4 clinical review auditor jobs found

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for creating or auditing a comprehensive estimate of damages for 1st and 3rd party material damage claims in either the auto or specialty lines leading to the proper disposition. Responsible for training, mentoring, controlling quality and providing technical assistance on material damage claims. National General is seeking a Field Auto Appraiser to join our Scottsdale , AZ Claims team . This is a remote, territory-based role that handles claims both virtually and in the field across the East Valley . The ideal candidate will reside in Scottsdale, Tempe, Mesa, Chandler, or...

Position Title Credit Review Officer Sr   Location Work From Home AZ, AZ 85001   Job Summary Internal Credit Review’s (ICR’s) Senior Credit Review Officer position is a key individual contributor role providing the incumbent diverse exposure to a variety of portfolios and products in support of ICR’s coverage mission. The Senior Credit Review Officer is responsible for continuously monitoring and periodically examining lending portfolio asset quality and credit risk management practices. This includes evaluating the adequacy of a business unit’s credit risk governance framework including risk appetite, policies, procedures, and risk reports; the depth, accuracy, and timeliness of client financial and transaction structure analyses, risk rating and regulatory classification assignment, and potential impairment for a sample of individual exposures; adherence to credit policies, procedures, and underwriting guidelines; and the quality of ongoing surveillance and problem loan...

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.    **This position can be performed remotely for candidates who reside in Arizona or New Mexico.** Essential Functions: Supervises assigned underwriting team. Enforces guidelines and procedures established by Corporate Office Underwriting.  Enforces underwriting guidelines and procedures specific to their branch territory.  Models smart and effective underwriting practices for individual accounts, all lines of business, and different classes.  Implements strategies to address challenges to profit and drive that message throughout the underwriting unit.  Answers questions, shares recommendations for complex situations,...

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. 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, concurrently or retrospectively in accordance with the appropriate...