- Premier Administrative Solutions (Clearwater, FL)
- …continual quality improvement. *Coordination of all activities of the Claims Department Management Team. This includes Supervisors and/or Team Leaders assigned ... Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. *Responsibility for final hiring decisions on… more
- PacificSource (Portland, OR)
- …to ensure strong operating performance, high levels of member satisfaction and quality performance, access, compliance and audit readiness, and sound financial ... impact and help people? Join PacificSource and help our members access quality , affordable care! PacificSource is an equal opportunity employer. All qualified… more
- EPIC Brokers (Grand Rapids, MI)
- …being in the office 5 days a week WHAT YOU'LL DO: In this Senior Client Manager role, you will be responsible for processing (during non-renewal periods) ... applications, policies, endorsements, binders, certificates, audit requests and other items related to the servicing of clients. Assists clients with policy… more
- EPIC Brokers (Melville, NY)
- …from client, carriers, Producers, Account Executives, attorneys and accountants Conducts pre- audit analysis and meets with client and carrier personnel at audits ... and practices while demonstrating the ability to meet service performance and quality standards Contributes to a team effort by accomplishing related results as… more
- Kaiser Permanente (San Diego, CA)
- Description: Job Summary: Manages the development of quality strategies in alignment with KFHP strategic priorities, mission, and vision. Manages the teams ... coordination across areas to recommend actions based on reviews of regional quality reports. Guides the identification of new opportunities for improvement and… more
- Chubb (Austin, TX)
- …coordinate efforts with Home Office/Product and Segment leaders. Corporate Underwriting Audit - Monitors underwriting quality and achieve Satisfactory score ... maintain mentoring / succession relationship with several High Potential Senior Underwriters and Team Leaders within assigned locations. Oversee workflows,… more
- Boar's Head Brand (Sarasota, FL)
- …to: Product Development : Conduct research on product appeal, sensory analysis, claims testing, and concept validation to guide the innovation pipeline. Shopper ... needs and behaviors and inform targeted product development and marketing communications. Audit and Elevate Current Practices : Conduct a comprehensive audit … more
- LanceSoft (White Plains, NY)
- …customers. *Prepare engineering calculations, estimates, and cost analyses for feasibility/ audit reports. *Manage and implement multiple lighting, HVAC, controls, ... related to customer bill savings, design and construction issues. Support the Senior /Lead Project Engineer and other senior engineers in negotiating change… more
- UnitedHealth Group (Eugene, OR)
- …senior leaders, legal/regulatory staff, government affairs, media relations, claims organization, security) Skills: De-escalating patients Extreme attention to ... member feedback, complaints, and grievances. Serve as primary resource to senior management, plan sponsors, enrollees, and regulatory agencies across Washington and… 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
- 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
- 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
- AIG (Atlanta, GA)
- Join us as a Senior Claims Adjuster to take on...to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ... key responsibilities within a world - class claims function. Make your mark in Claims ...claims expert and thought leader. + As a senior member of the team , you will act… more
- Commonwealth Care Alliance (Boston, MA)
- …not be considered at this time._** Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will ... 011250 CCA- Claims **_This position is available to remote employees...to support organizational decision-making, and identify opportunities to improve quality and control costs. Supervision Exercised: * No, this… more
