12 clinical review auditor jobs found

Job Description: Title: Billing Specialist – Shared Services   Remote:  candidates in Florida | Supporting:  Shared Services Seeking:  2 years of billing and account support experience, EPIC experience strongly preferred   Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. Additionally, our remote work policy includes having a dedicated, distraction-free workspace. Remote work is not a substitute for childcare, elder care, or other personal responsibilities during working hours. To view our branch locations, please visit: ioausa.com/locations    About the Role:  The Billing Specialist is responsible for processing Agency Bill transactions, including premiums, taxes, fees, installments, and...

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 Claims Assistant PRIMARY PURPOSE : To provide support to the claims staff and to perform other office tasks on a commercial automobile liability PIP department ESSENTIAL FUNCTIONS and RESPONSIBILITIES Annotate Mail and Medical bills Download and organize documents for adjusters Assist adjusters and supervisor with voicemails Sets up and enters new claims into claims management system when requested. Inputs and reviews notes/diaries in claims management system...

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 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, reports, and...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an opening for an Employee Benefits Account Management Team Lead for our St. Petersburg, FL  office. This team lead will be responsible for assisting in workflow strategy development, deployment and training, collaborating with producers to oversee assigned team including workflows, workload, adherence to agency policies and procedures; also responsible for conflict resolution, performance reviews, expense management and salary administration for assigned team. Essential Tasks: Overall management and support of team and Office Advocates, if applicable Interview and evaluate prospective team members Coordinate training and guidance regarding department procedures Assist in needs assessment and training where needed Assist with back up, when necessary Participate in disciplinary and termination issues Assist with implementation of...

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Senior Accountant is primarily responsible for complex accounting activities relating to the maintenance of a complete and accurate general ledger and the subsequent managerial reports and financial statements for assigned business units. The person in this position is also responsible for ensuring the integrity of account information by recording verifying, consolidating, and entering accounting transactions. A GLIMPSE INTO YOUR DAY Prepares and records asset, liability,...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Bridge Specialty Group   is seeking a   Processing Assistant   to join our growing team in   St. Petersburg, FL .    The Technical Service Assistant will support the clerical and administrative process of the Broker’s book of business for both renewals and new business.   How You Will Contribute: Develop a full working knowledge of Commercial Lines procedures. Handle client request for information, endorsements cancellations, and other services as required. Assist in analyzing insurance exposures and account summaries. Review policies, endorsements, audits, dividends, and quotations prepared by our carriers for accuracy and completeness. Preparation of binders, certificates, automobile identification cards, invoices, and similar items. Assist in resolving unbilled items, account differences...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...

The Baldwin Group is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk Management, Employee Benefits and Benefit Administration, Asset and Income Protection, and Risk Mitigation strategies to clients wherever their passions and businesses take them throughout the U.S. and abroad. The Baldwin Group has award-winning industry expertise, colleagues, competencies, insurers, and most importantly, a highly differentiated culture that our clients consider an invaluable expansion of their business. The Baldwin Group (NASDAQ: BWIN), takes a holistic and tailored approach to insurance and risk management. Directly supervises and leads a high-functioning team of risk placement professionals. Responsible for the overall function of marketing, underwriting, and placement of new business accounts submitted by the Sales Team and the consistent quality output of the Risk Placement...

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 or Tallahassee, 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...

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...