• Senior Quality Analyst, Claims

    Providence (WA)
    …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... claims environment, and respond positively to change.** **The Senior Quality Analyst performs all duties in a manner...and propose opportunity solutions and success replication. Propose monthly audit focus topics to claims leaders based… more
    Providence (08/01/25)
    - Related Jobs
  • Senior Nurse Auditor - Payment Integrity…

    Elevance Health (Mason, OH)
    …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Nurse Audit Senior ** will be ... **Nurse Audit Senior - Payment Integrity Complex...**Nurse Audit Senior - Payment Integrity Complex and Clinical ...as necessary . BA/BS preferred . Medical claims review with prior health care fraud audit more
    Elevance Health (07/30/25)
    - Related Jobs
  • Senior Compliance Coding Analyst…

    Houston Methodist (Houston, TX)
    …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
    Houston Methodist (05/30/25)
    - Related Jobs
  • Senior Claims Specialist

    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...practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the implementation of Management… more
    Axis (06/25/25)
    - Related Jobs
  • Senior Provider Audit Analyst

    Point32Health (Canton, MA)
    …contract interpretation in accordance to claims processing guidelines, Point32Health Medical and Payment Policies and established audit protocols. He/she ... (minimum): 5-7 years of related professional healthcare experience including familiarity with medical claims processing. + Preferred: 8-10 years of related work… more
    Point32Health (07/18/25)
    - Related Jobs
  • Business Audit - Senior Analyst…

    CVS Health (Springfield, IL)
    …a Regional Pharmacy Onsite Auditor, you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be based from your home ... and travel onsite to conduct claims audits at pharmacies throughout multiple states by reviewing...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
    CVS Health (07/16/25)
    - Related Jobs
  • Claims Manager

    CHS (Clearwater, FL)
    claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with… more
    CHS (05/09/25)
    - Related Jobs
  • Manager, Claims & Insurance

    American Water (Camden, NJ)
    …package including 401(k),Defined Contribution Plan, Employee Stock Purchase Plan, medical , prescription, dental and vision coverage, plus disability, paid time ... wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission.… more
    American Water (07/01/25)
    - Related Jobs
  • Sr. Risk Analyst, Cargo Claims

    Amazon (New York, NY)
    Description Amazon's Global Risk Management & Claims team is seeking a highly skilled and detail-oriented Senior Risk Analyst with a background in logistics, ... The ideal candidate will possess an in-depth understanding of insurance claims processes, global cargo regulations, and risk management in transportation. As… more
    Amazon (06/05/25)
    - Related Jobs
  • Sr. Risk Manager, Logistics Claims

    Amazon (TX)
    …The Program, Project, Product, and Vendor Management Team within Amazon's Logistics Claims Management and Operations group is seeking a motivated and experienced ... Senior Risk Manager. The ideal candidate will be familiar with insurance and claims programs, and insurance policies, have a history of success in procurement,… more
    Amazon (07/31/25)
    - Related Jobs