6 risk analyst ii jobs found

The Data Verification Analyst is responsible for all bill review clerical functions, including mail, prepping and scanning medical bills, data entry, data verification and assisting with various phone and email tasks to support the bill review department. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Validate incoming data to the Bill Review system Identify and apply customer-specific rules and processes Requires continual and consistent communication with supervisor regarding status of Data Verification queues and workload Assist the bill review department with all clerical duties as assigned Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to work on several concurrent tasks and prioritize workload with minimal direction Ability to identify, analyze and solve problems Basic computer proficiency, including familiarity with Microsoft Office applications Strong interpersonal, time management, and organizational...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost...

Job Responsibilities and Requirements Independently evaluates and synthesizes information in order to accept, modify, or rejects risks on a case. Has the ability to exercise independence and discretion in making final decision making of risk accepted/rejected.  Book of business and new business quote activity is comprised of both experience and manually rated cases. Utilizes experience in the industry, understanding of the client and marketplace to review and evaluate all assigned risks in the Group lines of business that includes plan design, experience, manual rates and provides guidance to sales, service, and all internal business partners to price and renew all business lines. The overall final case position is determined by the Underwriter II. Has a thorough understanding of our manual rating approach, including base rates and factors that drive claims cost changes. Understands PACS and evaluates inforce business for cross sell, enrollment, plan design changes...

Overview The Risk Control Consultant II serves as a business consultant, helping policyholders improve workplace safety, reduce losses, and strengthen risk management practices. The consultant partners with insureds across a variety of industries, provides technical guidance, and shares industry expertise with underwriting and senior management to support informed business decisions. Maintains a solid understanding of AmTrust's mission, vision, and values and upholds the standards of the organization.   This role will primarily service the Philadelphia area, with additional responsibility for South Jersey, Delaware, Maryland, Virginia, and DC. Responsibilities Provide risk control consultation and evaluation services to support the selection and retention of new and renewal commercial multi-line business. Prepare reports, analyze data, and identify injury and loss trends to assist underwriting and insured management in...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost...

The Workers’ Compensation   Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex lost-time workers’ compensation claims under close supervision 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...