7 clinical review auditor jobs found in Charlotte

This senior individual contributor role is accountable for architecture-level decisions, implementation, and operational ownership of secure, resilient AWS cloud-native platform capabilities supporting Velogica US within SCOR Digital Solutions. The position leads modernization of legacy scripts, tooling, and release patterns into Terraform/CloudFormation-based Infrastructure as Code, modern CI/CD, and standardized operational guardrails across development, QA, staging, Rescore, and production environments. The role partners closely with engineering, architecture, and security stakeholders to improve delivery speed, reliability, and compliance, and carries deep ownership of Amazon RDS/Aurora lifecycle management, performance, recovery readiness, and database-aware deployment coordination for business-critical services. Cloud-Native Platform Engineering (AWS) Design and operate resilient AWS platform capabilities across dev, QA, staging, Rescore, and production. Build secure,...

The Professional Review Analyst analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Candidate must be located in the greater Charlotte, North Carolina Region and able to attend in office training for a minimum of 1 week at start of employment. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical...

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: Provide process, design and analysis support for developing solutions for interfacing business applications. Drive requirements elicitation process for work efforts of all size and complexity. Work in an indirect leadership capacity to influence collaboration, communication and outcomes of various initiatives. Lead work on all phases of systems analysis up to the enterprise level of the organization's...

Company Details   Berkley Southeast is a member company of W. R. Berkley Corporation, a Fortune 500 Company, whose insurance company subsidiaries are rated A+(Superior) by A. M. Best Company. BSIG provides local underwriting, risk services, claim, marketing and audit services for agents and policyholders in Alabama, Georgia, Mississippi, South Carolina, North Carolina and Tennessee. We take a broad approach to underwriting for ‘best in class’ businesses, primarily in: construction, light manufacturing, wholesale, distribution and business service industries.   The Company is an equal employment opportunity employer.   www.berkleysoutheast.com Responsibilities Currently seeking a Manager who will directly supervise our Associate Underwriters.  Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training...

Job Description At AIG, we are reimagining the way we help customers to manage risk. Join us as Underwriting Audit Manager to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team and to work with some of the industry’s top talent. AIG Underwriting teams help to find insurance solutions in areas including Financial Lines, Property, Casualty, Specialty Lines, Cyber, and Multinational Clients. We are reimagining how we help customers to manage risk, transforming our operating model and reshaping our role responsibilities and career pathways. The goal is to unlock the full potential in each colleague – empowering our people to grow as insurance professionals and add more value to our customers and AIG. How you will create an impact The purpose of the Underwriting Quality Manager for Commercial Casualty and Programs is to determine adherence to the AIG Underwriting Control Framework....

Delivery Quality Lead - GenAI Be part of something groundbreaking  At AIG, we are making long-term investments in a brand-new, innovative Generative AI team, designed to explore new possibilities for how artificial intelligence can be applied in insurance and beyond, and we need your help.   With the support and investment needed to explore new frontiers in generative AI, you’ll be working alongside talented colleagues, innovating and leading projects that will transform how we manage risk and serve our customers.   This team is central to our vision of the future and the core of our business offering. We will incorporate best-in-class engineering and product management principles and your guidance and collaboration will be critical to its success. To rapidly advance and innovate, we need your skills and expertise to build and scale world-class products. If you’re excited by the opportunity to create meaningful impact, we’d love to hear from you.  Who we are...

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: The Privileged Access Management (PAM) Lead Engineer is responsible for the design, implementation, and oversight of the organization’s privileged access management program, ensuring protection and proper management of sensitive accounts and credentials. Collaborates cross-functionally to manage tools, develop/enhance policies, and respond to privileged access security incidents. Serves as subject...