8 risk analyst ii jobs found

CorVel is hiring a Medical Bill Review Analyst. The Bill Review Analyst is responsible for review, auditing and data-entry of medical bills for multiple states and lines of business.  This is a remote role. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines and PPO discounts.  Position requires knowledge of the Fee Schedule and the operation of the computer terminal May consult reference materials in the auditing process Requires regular and consistent attendance. Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP). Additional duties as assigned.   PRODUCTION REQUIREMENTS: Based upon situation or state specific issues meet 98% accuracy, 10,000+ keystrokes per hour   KNOWLEDGE & SKILLS: Knowledge of medical terminology, workers’...

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...

Position Title Credit Products Specialist II - Technology, Media & Communications   Location Charlotte, NC 28202   Job Summary The Credit Products Specialist II – Technology, Media & Communications plays a key role in structuring and underwriting complex commercial credit transactions while managing an assigned loan portfolio within a specialized vertical or region. This position is responsible for independently analyzing credit risk, negotiating loan terms, and providing strategic recommendations to relationship and credit teams. By proactively monitoring portfolio performance and identifying emerging risks, this role ensures sound credit decisions and long-term client success. The position also supports the professional development of junior team members by sharing expertise and best practices.   Job Responsibilities: JOB RESPONSIBILITIES Credit Structuring & Underwriting : Lead underwriting efforts for complex loan requests, assessing...

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of claims...

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of claims...

The Liability Claims Specialist (floater) assists the team with providing claims handling coverage when needed. This role aims to achieve optimal outcomes and continuity for both CorVel and our clients. The Floater handles litigated files and works with delegated limited authority for a variety of clients on a temporary basis, adhering to company best practices. This is a remote role. Candidates residing in the east coast are preferred. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Work with a variety of clients on a temporary basis to provide claims handling coverage during periods of high demand Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and liability position of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and...

Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security.   Information Technology  At AIG, technology is at the heart of everything we do, from underwriting risks to processing claims. The Information Technology team equips our employees with the latest tools to complete their work efficiently and with the highest standards of excellence. The team is responsible for shielding the company’s systems from security risks, while designing technology strategies that enable AIG’s businesses to achieve their goals. AIG’s Information...

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance? At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm—and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States. This position supports our workers' compensation line of business, Eastern...