11 clinical review auditor jobs found

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 Advocacy Coordination Team Specialist PRIMARY PURPOSE :   Actively researches, resolves, and administers escalated inquires for all lines of business, including but not limited to Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific leaves, accommodations, disability and statutory claims. Provides excellent customer service displaying care and empathy to callers regarding claims and executes technical and jurisdictional requirements...

Primary Details Time Type: Full time Worker Type: Employee Claims Specialist – Crop The Opportunity: In this role you will deliver prompt and accurate claims service to policyholders and agents for both multi-peril crop insurance (MPCI) and crop hail claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering insurance policies to ensure compliance with state and federal regulations.  You will partner with Field Claims Manager to ensure effective and efficient claims operations. • Location: Work Remotely in Iowa, USA • Work Arrangement: This role is fully remote, approximately 20% home office work and 80% field work. • The starting salary range for this role is between $64,000-$96,000 Your New Role: • Distribute and direct losses and claim tracking for defined territory or agency base to support delivery of effective customer...

UFG is seeking a Director - Internal Audit to provide strategic leadership and operational oversight for the planning, execution, and reporting of the audit function. Reporting directly to the VP, Internal Audit, this role is responsible for managing the audit lifecycle, evaluating the effectiveness of internal controls, and ensuring the audit team delivers high-quality results. The ideal candidate is a seasoned leader with extensive technical expertise, capable of driving department-wide initiatives and mentoring a team of professionals to meet the organization’s evolving risk landscape. Essential Duties & Responsibilities:   Collaborate with the VP, Internal Audit and business leaders to develop and implement a multi-year, risk-based internal audit plan. Oversee the end-to-end execution of the annual audit plan, ensuring all financial, operational, and compliance projects are completed on time and within budget. Lead the department-wide risk...

UFG is looking for an experienced P&C capital modeling professional charged with advancing our capital modeling, solvency assessment and stress testing framework.  As a member of the risk office, this position collaborates closely across all functions including underwriting, actuarial, finance, catastrophe modeling, and investment management. This position is a hands-on actuarial and financial modeling role with highly influential access to primary decision makers regarding capital management, reinsurance programs, and other corporate development activities requiring risk assessment and capital deployment.  This is a challenging role requiring strong technical ability, financial business acumen and excellent communication skills.  The Director - Corporate Risk Analysis will be involved in key strategic initiatives to assist in evaluating optimal outcomes of varied growth opportunities and capital management. Essential Duties and Responsibilities:...

Posting Title: Actuary Location: West Des Moines, Iowa (Mostly On-Site) Employment Type: Full-time About Us: EquiTrust Life Insurance Company is a national carrier of competitive, client-friendly annuity products sold through a variety of distribution channels, including more than 20,000 independent agents and independent marketing organizations (IMOs). Since 2003, we have provided exceptional customer service to our clients by operating with integrity and passion. Our efforts are supported by a dedicated workforce who execute their responsibilities through teamwork and an entrepreneurial spirit. EquiTrust sells products nationwide and is headquartered in Chicago, Illinois, with operations in West Des Moines, Iowa. How You’ll Contribute:...

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.   DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all....

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,...

UFG is currently hiring for a Reinsurance Accountant to assist in the preparation of accounting, reporting, and analysis of United Fire Group’s (UFG) reinsurance transactions. This role prepares supporting documents and performs procedures to ensure all ceded and/or assumed reinsurance activity is properly recorded in accordance with GAAP and statutory accounting principles while maintaining data integrity across subledger and financial reporting systems. Working closely with other members of the Reinsurance Team, the Reinsurance Accountant aids with treaty execution activities, cash settlements, and reconciliations. This individual also assists in implementing process improvements, strengthening internal controls, and supporting both external and internal audit requests. The ideal candidate demonstrates strong analytical skills, a principle understanding of reinsurance accounting practices, and the ability to work both independently and collaboratively in a complex...

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 Claims Assistant Claims Assistant Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near our Dynamic Center of Excellence📍 Dubuque, IA   : 4141 Westmark Drive, Dubuque, IA 52002 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and customers from some of the world’s most...

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 Disability Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near one of our dynamic Centers of Excellence📍 Dubuque, IA   : 4141 Westmark Drive, Dubuque, IA 52002   ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and customers from some...

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 Disability Representative Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near one of our dynamic Centers of Excellence Cedar Rapids, IA : 333 1st Street SE Ste.200 Cedar Rapids IA 52401 ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support employees and customers...