• Head of Liability Reinsurance Claims…

    Axis (New York, NY)
    …(both external and internal); ability to prepare reports, presentation materials and to explain claims data and cedent audit results + AXIS Culture and Values ... part in the selection process. AXIS is seeking a **_Head of Reinsurance Liability Claims and Manager of North America Reinsurance Claims Team_** to join our… more
    Axis (04/30/25)
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  • Pharmacy Claims Auditor CPhT

    Conduent (Dallas, TX)
    … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
    Conduent (05/31/25)
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  • Claims Team Lead - Auto Liability

    Sedgwick (Cincinnati, OH)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Auto Liability **PURPOSE:** To supervise the operation of a… more
    Sedgwick (06/07/25)
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  • Workers Compensation Claims Team Lead | New…

    Sedgwick (Rochester, NY)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | New York Jurisdiction Job Description We are seeking a… more
    Sedgwick (06/06/25)
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  • Claims Team Lead - Workers Compensation

    Sedgwick (Ontario, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation **PRIMARY PURPOSE:** To supervise the operation… more
    Sedgwick (06/06/25)
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  • Workforce Absence Team Lead - Claims…

    Access Dubuque (Dubuque, IA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Workforce Absence Team Lead - Claims Assistant Team **Sedgwick** 1 Positions ID: R61333...Financial Services & Insurance Workforce Absence Team Lead - Claims Assistant Team All eligible candidates must live near… more
    Access Dubuque (06/02/25)
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  • Workforce Absence Team Lead - Claims…

    Sedgwick (Dubuque, IA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Best Workplaces in Financial Services & Insurance Workforce Absence Team Lead - Claims Assistant Team All eligible candidates must live near our center of excellence… more
    Sedgwick (05/10/25)
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  • Workers Compensation Claims Supervisor…

    Sedgwick (Long Beach, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Best Workplaces in Financial Services & Insurance Workers Compensation Claims Supervisor | Long Beach, CA (Hybrid) | SIP...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
    Sedgwick (03/13/25)
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  • SR Regulatory Compliance & Audits Specialist,…

    Commonwealth Care Alliance (Boston, MA)
    …Experience (must have): * 5+ years in healthcare compliance, regulatory affairs, or claims audit . * Experience working with TPA partners (eg, Cognizant) and ... 011250 CCA- Claims Position Summary: Reporting to the Director, ...identify areas of risk or non-compliance. * Track internal audit findings and facilitate resolution through Corrective Action Plans… more
    Commonwealth Care Alliance (06/02/25)
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  • Payment Integrity: Reimbursement Policy Quality…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …preferred or equivalent experience or training + Minimum of 5 years claims audit /quality assurance experience in healthcare required + Strong understanding ... invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against plan enterprise warehouse claims … more
    Blue Cross Blue Shield of Massachusetts (05/11/25)
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