6 clinical review auditor jobs found in Alpharetta, GA

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is seeking an Underwriting Technician within the Bay Area to provide critical support to designated Underwriters, and their assigned agencies, assisting with the facilitation of the end-to-end underwriting process. This individual is responsible for ensuring submission quality, accurate data entry, timely policy processing, and coordination between internal teams and external partners, all contributing to efficiency, service excellence, process improvement, and the delivery of high-quality, audit-ready files.   Interested? We'd love to meet you!   ESSENTIAL RESPONSIBILITIES   SUBMISSION MANAGEMENT AND SUPPORT Reviews incoming submissions for completeness and quality, identifying missing or conflicting information and requesting additional details as needed. Accurately enters and maintains data in Underwriting and Policy Administration systems based on submission documentation and...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary: The Assistant Vice President within Arch Construction Southeast is responsible for the technical underwriting and account management of large account construction l oss sensitive casualty programs. Responsibilities and Accountabilities: Technical Underwriting Solicits and reviews new and renewal account information required to evaluate a risk. Identifies all potential exposures and hazards in relation to coverage requested and individual risk characteristics. Assesses insurance and related financial risk and structures appropriate loss sensitive program to effectively protect against frequency, severity, catastrophic and credit risk. Underwrites...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Plan and direct software engineering services for a major line of business or multiple lines of business to meet strategic and operational goals. Set the vision; establish effective standards/ processes; set/monitor quality performance expectations/results. Interface with senior executives across the enterprise to develop a strategic plan for delivering Information Technology (IT) solutions which...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where your clinical talent and leadership abilities contribute to our competitive edge.    PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of our Alpharetta, GA or Dallas, TX office. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively,...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! The position encompasses Property underwriting for the Markel Specialty Southeast Region. Specific focus for this role will to be to establish and grow the Property book of wholesale business in the Southeast territory. The primary purpose of this position is to underwrite new business and renewals in a profitable manner and according to authority level and established guidelines. The appropriate candidate will utilize underwriting tools to determine accurate classifications, rates, and premium charges....