- 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
- CVS Health (Hartford, CT)
- …regulation and identify process enhancement opportunities to reduce or eliminate risk of future client audit exceptions. This includes having an extensive ... as (but not limited to) benefit setup, prior authorizations, claims payment, and pharmacy contracting in order to review... process enhancement opportunities to reduce or eliminate risk of future audit exceptions, as well… 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)
- …risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission ... 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
- 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
- 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
- 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