940 claims auditor jobs found

Join Starr, a global leader in commercial insurance with over a century of expertise. We empower our employees to innovate, make impactful decisions, and build lasting client relationships worldwide. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a rapidly growing company that invests in its people and their ability to drive real progress. Claims Auditor – Commercial Insurance Industry Essential Job Functions: ·          This position is responsible for reviewing and evaluating closed and open claim files against our Claims Handling Guidelines or Best Practices to ensure that company procedures are followed.This will include claims handled by our Third Party Administrators (TPAs) as well as claims handled by our internal claims staff (Starr Adjustment Services) ·...

The Senior Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements. Your Impact Perform in-depth claims file reviews for accuracy and compliance. Document findings and provide recommendations for corrective action. Identify trends and collaborate with departments to improve claim practices. Support audit reporting and analytics. Successful Candidate Will Have Bachelor's degree preferred; CPCU, AIC, or other insurance certifications a plus. 4 - 6 years of claims or audit experience. Strong understanding of claims handling and insurance regulations. Analytical, organized, and skilled in Excel/audit systems. At Risk Strategies Company, base pay is one part of our total compensation package, which also includes a comprehensive suite of benefits, including medical, dental, vision, disability, and life insurance, retirement savings, and paid...

Starr Insurance Companies is a leading insurance and investment organization, providing commercial property and casualty insurance, including travel and accident coverage, to almost every imaginable business and industry in virtually every part of the world. Cornelius Vander Starr established his first insurance company in Shanghai, China in 1919. Today, we are one of the world’s fastest growing insurance organizations, capable of writing in 128 countries on 6 continents. On-site Location: Atlanta, GA    Alternate Locations:  Chicago, IL, Dallas, TX, Philadelphia, PA, Scottsdale, AZ Essential Job Functions: ·         This position is responsible for reviewing and evaluating closed and open claim files against our Claims Handling Guidelines or Best Practices to ensure that company procedures are followed.This will include claims handled by our Third Party Administrators (TPAs) as well as claims handled by our internal claims staff (Starr Adjustment Services) ·...

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance.   Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by  core values and operating principles  that guide every decision we make. The Claims Quality Assurance Auditor will conduct regular audits and assessments of Pie's claims handling processes to ensure adherence to Claims Best Practices, regulatory standards, and internal guidelines. This role is responsible for reviewing claim files for compliance, identifying areas of non-compliance, and recommending corrective actions to improve claims quality. The auditor will collaborate with Claims teams, prepare detailed audit reports, and support the development of quality control policies and training programs that drive continuous improvement in claims...

As a Medical Claim Lead Auditor, you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader and primary interface with administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims, resolve open issues, and draft the final report. You will contribute to the creation of new tools and approaches. The Responsibilities Conduct pre-implementation and coverage specific audits and accurately document and record all audit findings Understand client’s plans and apprise team of unique provisions/issues prior to audit Adjust workloads as necessary to achieve successful completion of project Clearly communicate and professionally interact with vendor and audit team Review documentation of potential discrepancies for thoroughness and accuracy Resolve post-audit activities in an accurate and timely fashion Write quality value-added draft report in a timely manner...

Job Title: Delegated Claims Authority & Outsource Manager Reporting to: Head of Claims Performance Position Type: Permanent, Hybrid working 3 days in the office, 2 working from home. Location:          City of London Why Tokio Marine HCC? Standing still is not an option in the current world of Insurance. TMHCC are one of the world’s leading Specialty Insurers. With deep expertise in our chosen lines of business, our unparalleled track record and a solid balance sheet, TMHCC evaluates and manages risk like no one else in the industry. Looking beyond profit, empowering our people and delivering on our commitments are at the core of our customer values, and so is a desire to grow and provide creative and innovative solutions to our clients. Job Purpose: To oversee and manage the Delegated Claims Authority and Outsource for the Claims function of Tokio Marine HCC International, ensuring: A ll types of DCA’s and non-DCA Service...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary: Conducts premium audits (both Physical & Virtual) for all lines of coverage across all business units of moderate to difficult complexity.  Handling of audit disputes received from insured/agents/brokers.  Ensures compliance and regulatory standards are maintained.  A desire to learn about all of the Arch specific business units and intricacies of these policies and the related exposures is expected.  Must possess the ability to read and interpret the coverages audited (Workers Compensation, General Liability, and Commercial Auto).  May be asked to mentor a less experienced auditor. Responsibilities and Accountabilities: Arranging premium audit...

CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role CCC is now hiring in Missoula, MT for a Vehicle Inventory Rep with target compensation of $200 per month with the potential to earn more plus mileage and new hire incentives. Vehicle Inventory Reps travel to specific automobile dealerships to...

If you're passionate about being part of a diverse organization that enables a Fortune 100 company with nearly $70 billion in annual sales to deliver innovative business solutions with excellence, then Nationwide's Legal team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This position is a critical member of Nationwide’s Alternative Risk, Reinsurance, and Insurance Claims legal center of excellence within the Office of the Chief Legal Officer (OCLO), supporting complex matters across the Nationwide enterprise. The role provides specialized legal and regulatory counsel on alternative risk financing strategies, reinsurance transactions, and insurance and reinsurance claims, including related coverage, regulatory, governance, and external audit matters for Property & Casualty and Financial Services...

Join Starr, a global leader in commercial insurance with over a century of expertise. We empower our employees to innovate, make impactful decisions, and build lasting client relationships worldwide. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a rapidly growing company that invests in its people and their ability to drive real progress. This position performs financial and operational audits of Managing General Agents (MGAs) and Third Party Administrators (TPAs), who underwrite and administer policies, collect premiums and adjudicate claims on behalf of Starr Companies. Responsibilities include: Perform testing, document test results, identify findings as applicable, and work with internal staff to design corrective actions that mitigate risk and ultimately add value. Responsible for...

Salary range is: $78,555.51 - $105,000.00 This position is bonus and/or commission eligible. CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role The Senior Internal Auditor supports the development and execution of audit programs addressing operational, financial, technology, compliance, and...

Position Title Recourse Source Specialist Location Nationwide, MI 48098 Job Summary Pay Range: 86-112K This job is responsible for mitigating the bank’s potential repurchase-loss risk, and providing cost savings to the company by refuting Demands made by Investor, Servicer and /or Mortgage Insurance (MI) Company partners.Pay Range: Local Minimum Wage - $0.00 - $0.00 Job Responsibilities: Manage the bank’s Repurchase, Make-Whole, MI Deficiency, and MI Curtailment potential loss exposure.  Ensure timely appeal / repurchase in accordance with various Investor, Servicer, and MI Company requirements.  Communicate with internal / external business partners regarding Demand-level issues, deliver repurchase root-cause analysis to management peer group, conduct monthly (or as needed) pipeline status calls, and elevate issues as warranted.  Participate in regulatory exams to assist senior management in the representation of the Claims Mitigation function. Manage and coach...

Salary range is: $78,555.51 - $120,000.00 This position is bonus and/or commission eligible. CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role The Senior IT Internal Auditor will assist in developing and executing comprehensive audit programs that are responsive to the operational, financial,...

CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role CCC is now hiring in West Allis, WI for a Vehicle Inventory Rep with target compensation of $400 per month with the potential to earn more plus mileage and new hire incentives. Vehicle Inventory Reps travel to specific automobile dealerships to...

CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role CCC is now hiring in Des Moines, IA for a Vehicle Inventory Rep with target compensation of $250 per month with the potential to earn more plus mileage and new hire incentives. Vehicle Inventory Reps travel to specific automobile dealerships to...

CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role CCC is now hiring in St. Francis, WI for a Vehicle Inventory Rep with target compensation of $400 per month with the potential to earn more plus mileage and new hire incentives. Vehicle Inventory Reps travel to specific automobile dealerships to...

The Claims Training Specialist is responsible for developing curricula to ensure adherence to CorVel’s best practice guidelines, special customer handling requirements, improve quality of audit metrics and overall claims outcomes. This includes ensuring that a designated geographical claims area of CorVel is equipped with an Operations workforce that can optimize its current and future goals and objectives, and deliver quality services that can meet our clients’ requirements and service expectations.  In order to efficiently execute daily responsibilities, the Claims Training Specialist must first obtain a deep understanding of the business to articulate what our claims model does and to clearly demonstrate all aspects of the Operations roles in order to be able to successfully conduct and oversee the department training.   Other duties to be carried out by Claims Training Specialist will include conducting classroom, virtual, and field training to internal employees/colleagues,...

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary responsibility is evaluating claim handling quality, accuracy, and timeliness in categories including but not limited to: coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. This role has the ability to interpret results and trends in order to deliver operational reporting, and participate in the development and presentation of training.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Model ethical behavior and executes job responsibilities in accordance with CorVel’s core values, ethics, and information protection policies Serve as technical QA lead to assigned offices or departments Lead QA projects and serve as primary coordinator for senior leadership of assigned offices Support...

The Quality Assurance Nurse is responsible for case management quality assurance and mentorship of operations staff, providing tools and calibrating processes, while ensuring consistent delivery of CorVel’s case management services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Develop, implement, and provide ongoing quality assurance calibration of processes as well as a case management mentoring, both managed and delivered at the operational level Educate and equip operations with performance measurement and reporting tools that can be used to objectively measure and grow operations Provide national account and regulatory quality oversight As applicable, provide oversight and management of URAC compliance and renewals Work with executive, general and case management department management to ensure the case management department successfully implemented and is adhering to CorVel standards (including quality assurance, reporting, and...

Our Commercial Lines department is seeking a Premium Auditor with strong organizational and time management skills. The field auditor will be responsible for performing audits of Commercial Lines policies in accordance with company, industry and government rules and regulations in order to establish appropriate classifications, exposures, and basis of premium for each insured in. This position will cover Middlesex, Somerset and Union County. Essential Duties and Responsibilities: Conducting Premium Audits on Commercial Lines policies, which can include multi-state and/or multi-line policies. Performing a thorough review of the policyholder’s records to identify the insured’s exposures to the coverage provided. Verifying employer classes, claimant information, tax identification numbers, and payroll for the audit period, as well as other appropriate information required to ensure a complete and thorough audit. Documenting and processing the audit to explain deviations...