- Grant Thornton (Philadelphia, PA)
- 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 (Trenton, NJ)
- …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
- NJM Insurance (Trenton, NJ)
- …limited to audit results, state and federal regulatory compliance changes, risk assessments, process flows, meeting discussions and action plans. + Prepare ... + Perform data analysis using data auditing tools/techniques to audit high risk business areas efficiently. +...to present to management. + Collaborate with the BPU, claims management, law and regulation, and internal audit… more
- Ryder System (Trenton, NJ)
- …**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
- IQVIA (Wayne, PA)
- … claims processing** . + Identify and manage **payment data related to claims , rebill, and manage overrides.** + Audit readiness and fraud detection-including ... key growth drivers and trends. + Leads the monthly management forecast process for **pharmacy rebate manufacturers.** + Recommends and implements system solutions… more
- Fujifilm (Trenton, NJ)
- …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
- Akumin (Philadelphia, PA)
- …opportunities for improvement. + Ensure data integrity across systems and support audit readiness. **Compliance & Risk Management** + Maintain up-to-date ... oversee all facets of the billing lifecycle, including charge capture, claims management, collections, cash application, denial resolution, and system optimization.… more
- Burns & McDonnell (Conshohocken, PA)
- …prime contracts, CM contracts, subcontracts, and change orders. + Participate in the risk review process . + Implement assigned sections of the Project Execution ... client, supplier and company commissioning and startup teams as needed. + Implement, audit , and oversee project documentation. + Implement process for confirming… more
- Burns & McDonnell (Conshohocken, PA)
- …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
- Penn Medicine (Bala Cynwyd, PA)
- …efficient and timely claim submission. . Review secured authorizations and pre-billed claims as needed to ensure they adequately reflect the procedures preformed . ... In partnership with coding colleagues, educate provider community through independent audit analysis to ensure knowledge and understanding of correct coding and… more
- Deloitte (Philadelphia, PA)
- …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 (Conshohocken, PA)
- …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
- Mallinckrodt Pharmaceuticals (Malvern, PA)
- …appropriate resolution and corrective action, if needed. Key steps of our process : + Assess concern and recommend an investigative approach + Develop investigation ... of active Compliance investigations Investigation Oversight & Support: + Investigations Process Support - Ensures effective functioning of our global investigations … more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... processes + Assist corporate actuaries in preparation of the annual Own Risk and Solvency Assessment report + Participate in programming, preparation, and… more