- 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
- The Cigna Group (Bloomfield, CT)
- …processes related to IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis program. ... develop and promote shared goals. The Quality Review and Audit Senior Analyst position recognizes experience in Risk...Risk Adjustment/CMS knowledge helpful + Understanding of medical claims submissions, helpful If you will be working at… more
- The Cigna Group (Bloomfield, CT)
- …risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission ... Job Summary: The Risk Adjustment Quality & Review Analyst in IFP...as needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma and… more
- Humana (Hartford, CT)
- …degree + 2 or more years of project leadership experience + 1+ year of audit , compliance, and/or risk experience + Must be passionate about contributing to an ... caring community and help us put health first** The Risk Management Lead acts as a consultant to the...and compliance partners to consult on initiatives and drive process excellence + Develop annual work plan for responsible… 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
- Molina Healthcare (Hartford, CT)
- …submissions to Regulators. * Leads efforts through local Data/Business Analysts to audit provider contract loads and claims payments to ensure compliance ... Plan leader and liaison for MHI Service Operations, including: Claims , Configuration Information Management, Enrollment, Contact Center Operations, IT, Provider… more
- Cardinal Health (Hartford, CT)
- …operations of the accounts receivable team, ensuring accurate and timely processing of claims , including denials and the maximation of cash flow. This role is ... flow. + Coordinate with billing team to ensure insurance claims are accurate and sent timely. + Assist with...external audits by providing requested documentation and explanations. + Audit weekly team member accounts for accuracy and training… 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