12 clinical review auditor jobs found

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where...

At FCCI, we focus on creating connections and building lasting relationships.  Our people truly make the difference.  Are you a dedicated team player who thrives in a diverse, innovative and upbeat culture?  Do you have strong team working skills, possess technical excellence, have a desire for continuous learning and have compassion and respect for others?  If so, FCCI Insurance Group is the company for you! Currently seeking an experienced professional to provide customer service for billing inquiries and handle other administrative and system related tasks in support of billing functions. This role focuses on managing billing operations related to property and casualty (P&C) insurance policies. The ideal candidate will ensure accurate and timely billing, maintain compliance with industry standards, and provide excellent service to both internal teams and external clients, including policyholders and agency partners. The  Billing Coordinator  will serve as front line...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a Commercial Lines Account Manager to join our growing team in Tallahassee, FL!       The Commercial Lines Account Manager provides commercial lines support in maintaining , expanding, and servicing assigned accounts.       How You Will Contribute:     Process daily mail, emails, faxes, and telephone requests for assigned accounts, ensuring timely handling of client needs.   Maintain and update client data in the system to ensure accurate and current account records.   Review applications, endorsements, and renewal requests for compliance with underwriting guidelines.   Prepare and process insurance documents including binders, policies, certificates, audits, and cancellations.   Validate...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of these Centers of Excellence:   Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826  Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344  PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description The Audit Consultant II plays a key role in supporting the execution of operational audits within a modern, Agile-based internal audit function. This individual partners closely with audit leads and business stakeholders to assess risk, evaluate internal controls, and deliver insights that strengthen business processes across Sales & Distribution, Allstate Canada, and Investments. This role is ideal for someone with a foundational audit background who is eager to grow their expertise, operate in a fast-paced, sprint-based environment,...

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more...

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 Maitland, FL or Boca Raton, FL 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,...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a Commercial Lines Account Manager to join our growing team in Jacksonville, FL!   The Commercial Lines Account Manager is responsible for servicing commercial insurance accounts by reviewing renewals, processing policy documents, responding to client requests, ensuring compliance with underwriting guidelines, and maintaining strong relationships with clients, carriers, and internal teams. How You Will Contribute:   Process daily mail, including faxes and e-mail, for assigned accounts Answer and process all telephone requests for assigned accounts Enter all required data into system to maintain current file data on all assigned accounts Review commercial applications, renewal requests and endorsements for adherence to underwriting authority and guidelines as established by the company’s...

Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It’s what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities – work / life balance, career progression, sustainability, volunteering – you’ll find like-minded people driving change at Howden. Role: Process Excellence Continuous Improvement Lead  Preferred locations include Miami, Charlotte, and Chicago, though outstanding applicants in other regions will also be considered. Why Join Howden US? At Howden, we’re not just building a business- We’re rewriting the rules of...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims,...

Job Summary This position is responsible for the oversight of complex and large exposure losses and will report to the National Casualty Claims Manager. The Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines is achieved. In addition, this position will report findings and make recommendations on current practices including the claim department’s performance on meeting regulatory standards. Job Responsibilities · Review home office casualty files, provide direction as required to ensure that handling is within best practice guidelines and local jurisdiction regulations. · Responsible for providing guidance and direction to claims staff in order to ensure proper handling and risk mitigation. · Provide authority and guidance on all bodily injury claims regarding coverage, liability and damages, as required. · Provide feedback to leadership and adjusting...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a Commercial Lines Account Manager to join our growing team in Tallahassee, FL!       The Commercial Lines Account Manager provides commercial lines support in maintaining , expanding, and servicing assigned accounts.       How You Will Contribute:     Process daily mail, emails, faxes, and telephone requests for assigned accounts, ensuring timely handling of client needs.   Maintain and update client data in the system to ensure accurate and current account records.   Review applications, endorsements, and renewal requests for compliance with underwriting guidelines.   Prepare and process insurance documents including binders, policies, certificates, audits, and cancellations.   Validate...