14 clinical review auditor jobs found

The Director, IT PMO & Vendor Management provides strategic and operational leadership for Baldwin’s enterprise IT portfolio governance and vendor value management functions. This role is accountable for executing the firm’s technology investment and vendor strategies, leading a multi-disciplinary team that governs how Baldwin prioritizes technology initiatives, allocates resources across ~400 IT colleagues, and optimizes value and risk across a diverse ecosystem of 200+ technology vendors. Reporting to senior IT leadership, this role translates enterprise and technology strategy into a coherent multi year roadmap for portfolio governance and vendor management. Additionally, this role establishes and continuously improves standards, operating models, and analytics that enable executive decision making on portfolio mix, risk, and return on investment. Further, this role owns the integrated view of project, resource, and vendor spend, and is responsible for driving cost...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a Information Security Analyst II, you’ll play a key role in safeguarding our organization by partnering with business teams to identify and assess operational and compliance risks related to new and existing products, services, and technologies across cybersecurity domains. You’ll contribute to risk oversight activities, support the development of risk mitigation strategies, and help ensure alignment with regulatory requirements and internal policies. Leveraging your foundational knowledge of cybersecurity and...

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...

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 Property Claims Assistant PRIMARY PURPOSE:  To provide support to the claims staff and to perform other office tasks depending on the client program. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Sets up and enters new claims into claims management system. Inputs and reviews notes/diaries in claims management system as instructed. Processes payments. Processes mail; handles filing, faxing and photocopying. Reviews, prepares, creates, and/or sends letters,...

Slide Insurance - Fun. Innovation Driven. Fueled by Passion, Purpose and Technology. At Slide, you will not only be part of a successful team, but you will also be a part of our Slide Vibe/award winning culture where collaboration and innovation are expected, recognized and awarded! What you will be doing: Conduct structured, less complex audits of operational processes and decisions (including claims processing, underwriting activities, and customer service interactions) using established QA guidelines, procedures, and tools. Accurately document audit results, findings, and observations in accordance with QA standards. Prepare clear and organized audit summaries and reports for review by QA leadership. Identify trends, patterns, and recurring issues within assigned audit areas and escalate findings appropriately. Collaborate with the QA team and cross-functional partners to support quality improvement initiatives. Participate in QA calibration sessions to...

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...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Part time   Exempt/Non Exempt:   Hourly Job Description:   Temp Insurance Operations Support – The Auto Club Group This is a Part-Time Temporary position for three months beginning 6/1/26 – 9/1/26. What you will do: Under minimal supervision, the Insurance Operations Support accurately processes a variety of updates and changes to Brokered Business and Branded files and accounts. Operations Support Conduct outbound telephone calls and correspond with customers to gather information, respond to inquiries, and resolve issues. Use knowledge of insurance policies and procedures to make recommendations to customers regarding accounts, additional coverage needed, or additional products needed. When necessary, review current policies, discuss coverage options, quote replacement coverage, and bind policies. Examine policy and...

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 Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:   Orlando, FL :   12650 Ingenuity Dr Orlando FL 32826   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...

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,...

Company: Marsh McLennan Agency Description: Award-winning, inclusive, Top Workplace culture doesn’t happen overnight. It’s a result of hard work by extraordinary people. More than 15,000 of the industry’s brightest talent drive our efforts to deliver purposeful work and meaningful impact every day. Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities. With over 300 offices across North America, we combine the personalized service model of a local consultant with the global resources of the world’s leading professional services firm, Marsh McLennan (NYSE: MMC). We are looking for a Client Executive to manage a high-profile book of business that is complex, generates substantial revenue and critical to the company; assist Producers in handling renewals, sale of new accounts, and rounding of existing accounts.  A day in the...

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...