- Axis (Alpharetta, GA)
- …available upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims...Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores… more
- Point32Health (Canton, MA)
- …service to our members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of ... to everyone in our communities. At Point32Health, we are building on the quality , nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard… more
- Houston Methodist (Houston, TX)
- …risk and identify and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of ... specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS**… more
- Grant Thornton (Los Angeles, CA)
- As a Healthcare Process Risk Senior Associate, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... include but are not limited to co-sourced and outsourced internal audit , internal control assessments, enterprise risk management program assessments, tests of… more
- CHS (Clearwater, FL)
- …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions on ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met.… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- New York State Civil Service (Islandia, NY)
- …State NY Zip Code 11749 Duties Description Under the direction of the Senior Workers' Compensation Claims Referee, the duties of the Workers' Compensation ... Orders of the Chair.* Performs related duties as required.* Coordinate with the Senior Workers' Compensation Claims Referee in the management of the Conciliation… more
- American Water (Camden, NJ)
- …wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission. ... As the Claims & Insurance Manager, you will be instrumental in...are not limited to: o Compliance with applicable Internal Audit , Sarbanes-Oxley mandates and other internal policies. o Monopolistic… more
- Dignity Health (Bakersfield, CA)
- …for audit purposes. - Collaborate with internal departments, including claims processing, UM, compliance, and provider relations, to develop and implement ... relationships with provider representatives. - Prepare and present detailed reports on claims research activities, findings, and outcomes to senior management. -… more
- CRC Insurance Services, Inc. (NC)
- …5. Train claims staff on new policies or procedures. 6. Oversee and audit claims process ensuring proper documentation was created in the system and/or ... Coordinators reviewing allocation of staff to ensure productivity and quality standards meet or exceed expected goals. 4. Review,...order to provide account loss ratios and claims history to senior management.… more