122 Legal jobs in Columbus

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The incumbent will also conduct or assist with provider and subscriber investigations to verify the validity of services and charges; will monitor internal referrals from sources such as claims, customer service, Medicare C&D Compliance, and Fraud Hotlines; will alert Investigators of the need for further analysis; will perform claims system extracts and create reports, graphs and charts to support case documentation; will prepare necessary correspondence to set and monitor provider and member claim system flags; will work with external vendors to recover confirmed over payments, coordinate payment of vendor invoices and coordinate request for an independent review determination ; will participate in various internal committees as assigned; will update departmental tracking logs such as consultant listings, provider/member flag tracker and certified mail; and will input and maintain current case information in applicable case management tracking systems.

ESSENTIAL RESPONSIBILITIES

• Claims Reviews/Investigation: Arrange for collection of claims and supporting data from internal and external sources including providers, customers and accounts; Review claims and supporting documentation to verify the legitimacy of medical and drug claim charges; Work with external vendors to recover confirmed facility and professional provider over-payments.

• Investigation Support: Assist with investigations: Assist in the interviews of customers and providers to obtain information in suspected fraud waste and abuse cases; Prepare reports and other information to document audit findings.

• Calculate over-payments in established fraud, waste and abuse cases. Identify all suspect activity included in the case, determine what lines of business were involved in the suspect activity, and measure over-payment by means of sampling or complete review.

• Data Analysis: Perform claims system extracts and create reports, graphs, and charts to support case documentation; Review reports and other information to identify claims and related documents requiring investigations based on pre-determined criteria, including review of suspect claims, Fraud Hot Line and internal referrals.

• Update departmental tracking logs such as consultant listings, provider/member flag tracking, record request tracking, vendor related, certified mail, etc.

• Maintain current case related information on all applicable case management tracking systems.

• Set and update member flags and monitor claims that suspend due to the flag.

• Other duties as assigned or requested.

EDUCATION

Required

• Associate's Degree

Substitutions

• 3 years of related and progressive experience in lieu of Associate's degree

Preferred

• None

EXPERIENCE

Required

• 3 years in Healthcare, Finance, provider office or related industry

Preferred

• Experience in processing Blue Card, Local and FEP claims

• Experience in working with SAS

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Certified Professional Coder (CPC)

SKILLS

• Demonstrated proficiency in using Excel and Word

• Knowledge of medical terminology

• Demonstrated strong multi-tasking and organizational skills

• Demonstrated strong verbal and written communication skills

• Demonstrated proficiency in using OSCAR, INSINQ, ICIS, and COR or experience with other claims related processing platforms

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$21.53

Pay Range Maximum:

$32.30

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J

Objectives Incumbent is responsible for performing the essential job functions as assigned. The main objective of a Deputy Clerk is to receive, prepare and process the legal documentation necessary for all case types in the Delaware County Probate Clerk, Deputy, Office Manager, Officer, Microsoft, Retail

We're recruiting for a senior-level Litigation Docketing Specialist to join our client's Columbus legal team. This role requires advanced expertise in rule-based calendaring systems and the ability to lead, train, and support docketing staff while ensuring accuracy and compliance across multiple jurisdictions.

Key Responsibilities:

1. Interpret legal documents to identify and calendar critical litigation dates.
2. Create and update events in Aderant CompuLaw; calculate dates manually when needed.
3. Maintain precise docket data and generate reports for litigation teams.
4. Research and track changes to federal, state, and local court rules and procedures.
5. Develop training materials and mentor docketing staff on procedural updates.
6. Collaborate with attorneys, staff, and court personnel to resolve docketing questions.
7. Support the Docketing Manager with special projects and firm-wide initiatives.

What You'll Need:

• 57 years of docketing experience with CompuLaw, CourtAlert, or eDockets.
• Strong knowledge of litigation processes and court rules.
• Skilled in MS Office; Relativity Certified Administrator credential preferred.
• Excellent communication skills and ability to work under tight deadlines.

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Sr. Functional Bus Consultant (Compliance) - Remote

Job Description

The Senior Functional Business Consultant The Functional Business Consultant serves as a project manager , business system or business process subject matter expert with a high level of understanding of their assigned area. This position will represent their area of expertise with regard to business system knowledge on internal and client projects, regulatory requirements, process improvement, advanced research, root cause analysis, complex issue research, documentation, advanced communications, client interaction, training, testing, ongoing system support, and developing reports and coordinating audits.

Responsibilities

• Represents assigned business system or business process as a subject matter expert in business requirements, system specifications, process flows, process change and/or project management

• Provides leadership to the business in the identification and adoption of operational best practices and standard operating procedures as it relates to assigned business system or business process

• Independently researches, determines root cause and collaborates with others to resolve complex business and technical issues and customer inquiries.

• Provides prompt and thorough resolution for client and/or member satisfaction

• May facilitate testing for new or improved systems or processes including creation of a test plan, identifying test cases, and performing or leading User Acceptance and Joint Cycle Testing

• May provide guidance, mentoring, and work direction to others on the team

• Other duties as assigned

Education & Experience

• Bachelor's degree in business administration, IT or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 5 years of work experience in business analysis, project management, and/or process improvement to include:#3 years of functional experience in at least one of the specific areas for position (e.g., claims, eligibility, product, benefits, implementations or related area)

• Must be eligible to work in the United States without need for work visa or residency sponsorship

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• Proven client service skills with a track record for building strong client relations

• Implementation experience

• Thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical

• Self learns new processes/software to solve analytic problems

• Expert interpersonal skills necessary to drive results and deliver on commitments in a collaborative fashion

• Skillful at meeting facilitation, conflict management, and consensus building

• Capable of handling multiple projects simultaneously and ability to work under pressure with strict timelines in a fast-paced work environment

• Excellent verbal and written communication skills with prior experience giving presentations

• Proficiency in Microsoft Word, Excel, Project, PowerPoint, and Visio

Preferred Qualifications

• Rx Claims system proficiency

• Previous PBM or healthcare experience

• Advanced experience using queries

Physical Demands

• Occasional non-standard hours and travel may be required

• Constantly required to sit, use hands to handle or feel, talk and hear

• Frequently required to reach with hands and arms

• Occasionally required to stand, walk and stoop, kneel, and crouch

• Occasionally required to lift and/or move up to 10 pounds

• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. ? ?

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at or email

• Operate and maintain the landfill gas collection system in order to meet regulatory requirements and achieve performance standards;
• Coordinate repairs and modifications necessary to maintain and operate the landfill gas and leachate collection systems in a cost-effective manner;
• Inspect, repair, and/or modify wells, wellheads, collection lines, condensate traps, migration probes, vaults, flares, leachate lines, pumps, and associated equipment as directed;
• Implement environmental policies and compliance procedures applicable to SWACO facilities related to all permits, programs, and plans;
• Calibrate and maintain meters and equipment as required, and schedule factory required calibration/maintenance as necessary;
• Monitor sample points such as gas collection wells and gas probes, and record data by hand and/or electronically;
• Conduct landfill field testing using portable instrumentation such as GEM 2000/5000, Elkins Envision, FID's, LEL meters, and water level meters;
• Perform periodic maintenance checks on all SWACO's explosive gas monitoring systems, including gas probes and methane monitors, and assists in the preparation of reports to regulatory authorities;
• Adjust landfill gas flow rates from wells, as necessary, to minimize gas emissions from the field and optimize flow to the high BTU facility;
• Maintain a gas collection field log in various electronic forms to manage the project and resources effectively including production and quality deliverables;
• Weld and fabricate High-Density Polyethylene (HDPE) pipes;
• Troubleshoot and repair affected monitoring and pumping systems;
• Organize and store data
• Monitor, sample and log surface water at all SWACO facilities;
• Conduct other environmental sampling and inspections for SWACO facilities, assure integrity of samples, and forward samples to testing laboratory;
• Perform Quality Assurance / Quality Control function on environmental laboratory data reports and statistical reports;
• Utilize GPS to check grades, references, and points of pipe installation; and
• Recommend equipment and parts purchases.

• None

• High school diploma or GED required;
• Experience with landfill gas collection and environmental sampling or monitoring preferred, and
• College classes in environmental studies preferred.

• Knowledge of air compressor systems, hydraulic, pneumatic, and electrical pumps, principles, troubleshooting and repair;
• Proficient in data management and reporting using Microsoft Word and Excel;
• Operate light, medium, and heavy equipment;
• Apply common sense understanding to carry out instructions furnished in written, oral, electronic, or diagram form;
• Reason through problems and faults to arrive at safe and prompt resolution;
• Work competently and rationally under emergency and urgent situations;
• Maintain and repair sampling/monitoring and mechanical equipment;
• Read and interpret documents such as safety rules, operating and maintenance instructions/ manuals, and procedure manuals;
• Read and comprehend simple instructions;
• Draft correspondence and memoranda;
• Add and subtract two-digit numbers and multiply and divide by 10's and 100's;
• Perform basic mathematical functions using units of United States currency and weigh measurement, volume, and distance;
• Must be reliable, dependable, and report to work on a consistent basis;
• Must have the ability to work independently as well as collaborate within a team;
• Maintain a positive work atmosphere by behaving and communicating in a manner that promotes good relationships with customers, clients, co-workers and management;
• Demonstrate good interpersonal skills and the ability to work with individuals of diverse backgrounds;
• Valid Ohio Driver's License, and
• Valid Ohio Commercial Driver's License (CDL) Class A or B and Department of Transportation (DOT) Medical Card preferred.

• While performing the essential duties of this position, the individual is regularly required to climb, lift, balance, walk, stoop, twist, and kneel; considerable use of the arms and legs, including use of hands to finger, handle or feel; reach with hands and arms; and talk and hear;
• The individual will regularly lift and/or move up to 50 pounds and occasionally lift and/or move 75 pounds or more;
• Will also climb ladders, use power tools and noise producing tools and equipment, work in heavy traffic conditions, and enter spaces with limited working area;
• Specific vision abilities required by this job include near, far, corrected, and the ability to adjust focus, and
• Personal Protection Equipment (PPE) requirements as needed: hard hat, safety glasses, high visibility garment, work gloves, steel toe boots with steel shanks, and paper respirators.

• Work is completed outdoors approximately 75% of the time. Significant exposure to weather conditions, heat, cold, noise, dust, odors, fumes, and mechanical and electrical hazards;
• Work may be performed near moving mechanical parts, in elevated dangerous conditions, and outdoors, and
• Must be available for emergency call, shift work, and mandatory overtime.

Make banking a Fifth Third better® We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank.

GENERAL FUNCTION: Assist the Compliance Director of the Swap Dealer, Capital Markets and Volcker in the development and implementation of Fifth Third Bank's Swap Dealer, Capital Markets and Volcker compliance programs. This includes non-securities regulations covering interest rate swaps, foreign exchange swaps, other derivatives, commodities, and the Volcker Rule across the Bancorp. This position requires in-depth knowledge of Dodd Frank regulations governing Swap Dealers (Title VII), including Commodity Futures Trading Commission ("CFTC"), National Futures Association ("NFA") and Office of the Comptroller of the Currency ("OCC") requirements as they relate swap dealing and applicable derivatives trading.

DUTIES & RESPONSIBILITIES:

• Assist the Swap Dealer Compliance Director in developing and overseeing the regulatory aspects of the Swap Dealer, Capital Markets and Volcker compliance programs

• Create and maintain relevant policies and procedures

• Perform monitoring and surveillance of business and compliance processes to reasonably ensure adherence to regulatory requirements

• Assist in the development and delivery regulatory employee training programs

• Asset the Swap Dealer Compliance Director with regulatory inquiries and examinations

• Maintain knowledge of industry and regulatory updates and assess business impact

• Provide periodic reports to LOB and Compliance management on industry and regulatory trends, state of the program and the status of key initiatives

• Develop and maintain relationships between Compliance Risk Management, Line of Business leaders, Market Risk Management, Operations and the Legal Department to ensure the implementation of an effective compliance program

• Actively promote a solution-oriented environment

• Maintain networks with industry working groups that are dedicated to Swap Dealer, Capital Markets and Volcker compliance to benchmark and share best practices

• Support the Compliance Department's goals of achieving optimum team and individual performance

SUPERVISORY RESPONSIBILITIES: NONE REQUIRED

KNOWLEDGE & SKILLS REQUIRED:

• Bachelor's degree required

• Minimum of 5+ years proven experience in OTC derivatives businesses, specifically FX, Commodities, and Interest Rates

• Minimum of 3 years of experience with the implementation of Swap Dealer regulations

• Understanding of commodities laws, regulations and requirements, including industry practices and products

• Experience with and knowledge of Volcker Rule requirements and compliance program processes preferred

• Excellent written and verbal communication skills

#LI-GM1

Compliance Officer II- Swap Dealer

Total Base Pay Range 80,500.00 - 169,100.00 USD Annual

At Fifth Third, we understand the importance of recognizing our employees for the role they play in improving the lives of our customers, communities and each other. Our Total Rewards include comprehensive benefits and differentiated compensation offerings to give each employee the opportunity to be their best every day.

The base salary for this position is reflective of the range of salary levels for all roles within this pay grade across the U.S. Individual salaries within this range will vary based on factors such as role, relevant skillset, relevant experience, education and geographic location. In addition to the base salary, this role is eligible to participate in an incentive compensation plan, with any such payment based upon company, line of business and/or individual performance.

Our extensive benefits programs are designed to support the individual needs of our employees and their families, encompassing physical, financial, emotional and social well-being. You can learn more about those programs on our 53.com Careers page at: or by consulting with your talent acquisition partner.

LOCATION -- Cincinnati, Ohio 45202

Fifth Third Bank, National Association is proud to have an engaged and inclusive culture and to promote and ensure equal employment opportunity in all employment decisions regardless of race, color, gender, national origin, religion, age, disability, sexual orientation, gender identity, military status, veteran status or any other legally protected status.

Job Title:

Location:

What you'll do:

• Interpret and effectively communicate compliance management information, identify the root cause(s) of potential compliance risk, provide advice on addressing risk and strengthening controls, as well as provide periodic reports to management.
• Monitor the progress of compliance issues, analyze risk mitigation strategies and tactics, and validate effectiveness of corrective action plans by the line of business.
• Identify opportunities for improvement in the design and effectiveness of compliance controls as appropriate for first line business units, issue final reports and communicate results in writing to first line management or risk committees.

What you'll need:

• 2+ years of related experience in Regulatory Compliance, Risk Management, Internal Audit or similar field.
• High school diploma required; Bachelor's degree in related field preferred.
• Intermediate knowledge of general banking operations, including deposit operations, loan administration, treasury management and/or other commercial banking products and services.
• Intermediate knowledge of applicable regulatory and legal compliance obligations, rules and regulations, industry standards and practices.
• Intermediate understanding of MS Office.
• Intermediate ability to foster and build relationships to achieve a common goal.
• Intermediate speaking and writing communication skills.

Benefits you'll love:
We offer all the important things you'd want - like competitive salaries, an ownership stake in the company, medical and dental insurance, time off, a great 401k matching program, tuition assistance program, an employee volunteer program, and a wellness program. In addition, you'll have the opportunity to bolster your business knowledge, learning the ins and outs of how successful companies operate and manage their finances, giving you invaluable hands-on experience to help grow your career!

About the company:

Western Alliance Bank is a wholly owned subsidiary of Western Alliance Bancorporation. Alliance Bank of Arizona, Alliance Association Bank, Bank of Nevada, Bridge Bank, First Independent Bank, and Torrey Pines Bank are divisions of Western Alliance Bank; Member FDIC. AmeriHome Mortgage is a Western Alliance Bank company.

Western Alliance Bancorporation is committed to equal employment and will consider all qualified applicants without regard to race, sex, color, religion, age, nation origin, marital status, disability, protected veteran status, sexual orientation, gender identity or genetic information. Western Alliance Bancorporation is committed to working with and providing reasonable accommodations for individuals with disabilities. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process and/or need an alternative method of applying, please email or call . When contacting us, please provide your contact information and state the nature of your accessibility issue. We will only respond to inquiries concerning requests that involve a reasonable accommodation in the application process.

Western Alliance Bancorporation

Director of Cybersecurity and Privacy Risk Advisor

About the Company

Prestigious international law firm

Industry
Law Practice

Type
Privately Held

About the Role

The Company is in search of a Director, Cybersecurity and Privacy Risk Advisor to spearhead the advancement of its Information Security Governance and Risk functions. The successful candidate will be responsible for the creation, renewal, and maintenance of all relevant policies, standards, processes, and procedures in line with the organization's Information Security Policy. This role involves coordinating and prioritizing key activities, formalizing cyber risk controls, and leading the team to ensure compliance and continuous control monitoring. The Director will also be tasked with establishing a library of processes and procedures, as well as developing plans for the continuous improvement of Information Security Governance and Risk services. Applicants must demonstrate a proven track record as thought leaders in solving complex IT-risk management issues, with a strong background in the identification, development, and oversight of cybersecurity policies and procedures. The role requires expertise in tools and technology for data analytics on cyber threats, risks, and vulnerabilities, as well as the ability to prepare and communicate effectively across the organization. A Bachelor's degree, at least 15 years' of work experience, and a minimum of 10 years of supervisory experience are essential. The ideal candidate will have a background in the Information Technology or Information Security sector, with a preference for those who have worked in a professional services or legal environment. Expert knowledge of project management best practices and a working understanding of the NIST Cybersecurity Framework and IT Service Management are also necessary.

Travel Percent
Less than 10%

Functions

• Information Technology

• Exceptional interpersonal skills and ability to build strong relationships
• Excellent verbal and written communication skills
• Self-motivated & comfortable working independently
• Health-related sales experience is preferred but not required

• Comprehensive, on-demand training offered
• 100% commission-based opportunity with uncapped earning potential + monthly bonus incentives