2 claims auditor jobs found in Latham, NY

Overview As a Zonal Vice President of Workers’ Compensation Claims, you will be responsible for leading a team of 150+ claim professionals responsible for adjudicating claims throughout the Northeastern United States. Delivery of optimal technical outcomes and customer experience will require strong knowledge of industry best practices in claim investigation, disability management, litigation management, medical management, and claim evaluation and resolution. Requires strong knowledge of cross functional support groups and the ability to work in partnership with them to include Managed Care, Legal, SIU, Operations and Analytics. Additional responsibilities include resource planning, talent selection and development, regulatory compliance and the ability to use data, analysis and improvement plans to deliver corporate goals and objectives. Responsibilities Lead a team of 150+ claim professionals responsible for adjudicating...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has a need for Clinical Review Nurse remote or in an office  location.     PRIMARY PURPOSE:   The Clinical Review nurse has the responsibility of reviewing the medical necessity, appropriateness, quality and efficiency of services in the appropriate setting for Workers’ Compensation claimants. This position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the AmTrust Claims Adjuster team to expedite medically necessary treatment for each claim.  They also review pharmacy authorizations to determine appropriateness of pharmaceutical treatment.  Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.   This position will be hybrid out of one of our AmTrust office locations!  Responsibilities...