- USAA (Charlotte, NC)
- …associated with the current material processes, product lines, services, functions. Ensures quality audit work within required completion timeframes of each ... makes us special and impactful. **The Opportunity** As the ** Audit Services, Claims (Executive)** , you will...for area of responsibility + Provides independent assurance to senior management on the effectiveness of the design, implementation… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview** Reporting to the Manager, the ** Senior Data and Quality Analyst** will be part of our provider network compliance and reporting team. You will ... Lead Analyst on the team, proofs work of Data Quality and Audit Analysts, and also trains...Must have previous experience working with healthcare data or claims data + Bachelor's Degree OR In lieu of… more
- AIG (Atlanta, GA)
- …Services Partners, while monitoring SLA's and quality . + Partner with Compliance, Audit , Claims , and IT providing direction and support for SOX and SOC1 ... help customers to manage risk. Join us as a Senior Claims Business Analyst to play your...questions, etc. as well as the remediation of system-related audit findings and improvement opportunities. What you'll need to… more
- 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
- Axis (Red Bank, NJ)
- …& Quality Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the implementation ... + Set accurate claim reserves and make referrals to senior members of the team where necessary + Review...Plans for all claims groups in Axis Claims . + Responsible for Cycle time, Severity, Quality… 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
- 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
- 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
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