- Grant Thornton (Hartford, CT)
- As a Process Risk & Claims Audit Manager, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand ... and help you achieve more, confidently. Your day-to-day may include: + Leverage claims operations experience and claim audit experience to review and analyze… more
- Sedgwick (Hartford, CT)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- The Cigna Group (Bloomfield, CT)
- …(HCC) expertise, evaluating data accuracy and record compliance, executing on audit requirements, and identifying and recommending process improvements within ... The Quality Review & Audit Senior Analyst exhibits expertise in evaluating complex...medical diagnosis coding * Familiarity with CMS regulations for Risk Adjustment programs helpful. * Medical claims ,… more
- Ryder System (Hartford, CT)
- …**SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling ... issues, and complex and high exposure bodily injury and property damage claims . **Maintain an active inventory of claims , ensuring appropriate follow-up,… more
- CVS Health (Hartford, CT)
- …investigative process . This collaboration ensures a holistic approach to risk management and resolution. + **Technology Integration** : Advises on the selection ... Investigations Unit (ISIU) and is designed to lead complex investigations into high- risk and sensitive matters that may compromise the integrity of the… more
- Fujifilm (Hartford, CT)
- …assessment. Support development of new or updated polices to address new risk areas or to improve operations and/or internal controls. + Conduct healthcare, ... anti-corruption, antitrust, anti-corruption, and anti-money laundering compliance risk analysis. Identify potential areas of compliance vulnerability and risk .… more
- Burns & McDonnell (Wallingford, CT)
- …Negotiate prime contracts, CM contracts, subcontracts, and change orders. + Participate in risk review process . + Implement assigned sections of the Project ... client, supplier and company commissioning and startup teams as needed. + Implement, audit , and oversee project documentation. + Implement process for confirming… more
- Nuvance Health (Danbury, CT)
- …Integrity Team in the development of charge reconciliation reports and supports all audit , CDM and revenue and usage activity. Responsible for assisting in the build ... system wide CDM Tool as well as developing a process with IT to interface all charges and new...and concerns. Supports the activities of the Charge Integrity Audit Team by running reports and processing changes. Works… more
- Deloitte (Hartford, CT)
- …to clients in the insurance industry across business functions such as underwriting, claims , IT, finance and accounting + Coordinating with the client's tax and ... law and drafting technical memos + Assisting with IRS audit defense. The Team At Deloitte Tax LLP, our...operations while working within the confines of their individual risk profiles. Business Tax subject matter experts and industry… more
- Burns & McDonnell (Wallingford, CT)
- …client, supplier and company commissioning and startup teams as needed. * Implement, audit , and oversee project documentation. * Implement process for confirming ... related items. * Participate in internal and external project risk reviews and consult with Legal Department as required....oversee the downstream Request for Proposal (RFP) and bid process and prepare detailed scope of work documents for… more
- AIG (Wilton, CT)
- …with Reinsurance collection on billing and cash application + Support the audit process with external and internal auditors Qualifications: + Bachelor's ... insurance company + Advanced knowledge of reinsurance operations, including underwriting, claims , accounting, finance and associated process , controls and… more