18 clinical review auditor jobs found

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 Sr. Medicare Associate PRIMARY PURPOSE To gather documentation required to complete Medicare Compliance referrals in a timely manner; to upload referrals to Medicare Compliance System (MCS); to review the pay histories and medical records for adequacy; and to resolve technically difficult record files. ESSENTIAL RESPONSIBLITIES MAY INCLUDE Reviews JURIS pay ledger as a guide to locate medical records needed for MCS assignment; analyzes additional...

If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. #LI-CL1 Job Description Summary Do you thrive in an environment where you can put your critical thinking and communication skills to work every day? Do you appreciate being able to contribute individually as well as collaboratively? Our Surety Underwriting team values initiative, the ambition to grow and learn, a broad skill set that includes everything from marketing to finance to risk analysis and a solutions focused approach. We’re technology savvy and...

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℠. Arch Insurance Company is seeking a motivated actuarial candidate to join a dynamic reserving and loss analytics team. Reserving-related engagements account for the majority of the role, with the remainder dealing with financial reporting, profitability studies, and claim analytics engagements. This position will require application of the latest actuarial approaches to ensure appropriate reserve adequacy and reporting, as well as innovative thinking to help drive newly developed strategic vision and leverage available data, industry information, foundational analytics for critical decision making, and help with development of analytical tools and insights. The ideal candidate...

Sr Data Engineer - GE07BE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.              The Hartford seeks a driven, team-focused Senior AI Machine Learning Engineer to build Machine Learning Operations (MLOps) services for the Customer Operations Data Science team. The Hartford is developing industry ‑ leading AI and machine learning capabilities to improve customer experience (CX) at scale. Within Customer Operations Data Science, we build modern AI products that optimize customer interactions across omnichannel journeys, supporting operational areas such as the Contact Center, Premium Audit, and Billing. As a Senior Machine Learning Engineer , you will play a critical role in designing, building, and operationalizing...

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 Clinical Team Lead PRIMARY PURPOSE :  To supervise the operation of Disability Clinical Consultants for disability clients; to monitor colleagues’ workload, provide training and monitor individual claim activities; to provide clinical direction to Disability Clinical Consultants; and to review complex cases as appropriate. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Acts as clinical liaison for the claims team to ensure understanding of the Nurse...

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 Advocacy Coordination Team Specialist Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:      Dubuque, IA   : 4141 Westmark Drive, Dubuque, IA 52002  Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401  Coralville, IA:  3273 Ridgeway Drive Coralville IA 52241  Dublin, OH : 5500 Glendon Court Dublin OH 43016  New Albany, OH : 7795 Walton...

Overview T he Underwriting Assistant provides critical administrative and operational support to new and renewal underwriters. This role helps ensure efficient underwriting processes by managing correspondence, preparing files, and completing tasks that support timely and accurate policy issuance and renewal. Responsibilities · Prepare and review underwriting files for new and renewal business to ensure completeness and accuracy · Monitor and manage underwriting-related email correspondence · Review loss control reports and other supporting documentation to assess acceptability of risks in accordance with regional underwriting guidelines · Evaluating risk experience relative to the applicable class of business · Assist with policy rating activities, including rating new policies or verifying accuracy of previously rated policies · Review and process requests related to cancellations, endorsements, and other policy...

Company Details         Berkley Select delivers professional liability insurance solutions to individuals, businesses, professional services firms, and nonprofit organizations.   As a Berkley company, Berkley Select is staffed with a team of experts with a specific focus on Professional Liability.   Berkley Select utilizes individual risk underwriting, loss control, and claims practices to provide superior products and services to its customers.   Berkley Select is a Berkley Company. W. R. Berkley, founded in 1967, is one of the nation’s premier commercial lines property casualty insurance providers. W. R. Berkley Corporation (NYSE: WRB). Responsibilities Berkley Select is evolving its operating model to support continued growth, increased underwriting complexity, and greater use of data, automation, and AI-enabled capabilities.   The Senior Operations Analyst plays a critical role in advancing this...

Company Description WTW is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth. With roots dating to 1828, WTW has 40,000 employees serving more than 140 countries. We design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital to protect and strengthen institutions and individuals. Our unique perspective allows us to see the critical intersections between talent, assets and ideas – the dynamic formula that drives business performance. Together, we unlock potential. Learn more at  wtwco.com . Description The Associate Client Advocate (ACA) client-facing functions utilizing the colleague’s advanced skills in Commercial Property and Casualty Insurance and is responsible for a blend of internal delivery activities. The ACA is responsible for supporting client relationships, strategy development, and execution at the insurance program level....

Position Summary The Director of Data Engineering is responsible for building and operating the data engineering function within Ryan Specialty’s corporate data organization. This role is accountable for the silver and gold layer of the medallion data architecture thus transforming raw ingested data into clean, conformed, and business-ready data assets that serve as the foundation for downstream consumption. Beyond technical delivery, this role builds and scales a high-performing engineering team, establishes disciplined software development practices, and manages the contractor and external parties that augment internal capacity. An ideal candidate should be collaborative and dynamic and be able to work across the organization on a fast-paced and quickly evolving team. The leader will have five primary responsibilities: 1. Own and deliver the silver and gold layer of the medallion data architecture 2. Establish and enforce a standardized software development lifecycle for...

About HUB In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the world’s largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected — through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of-a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. Why Choose HUB? Throughout our network of more than 550 HUB offices in North America, we offer a competitive, exciting and friendly work environment that strategically positions our employees for longevity and success. At HUB, we believe in investing in the future of our employees and provide continuous opportunities for growth and development. Our entrepreneurial culture fosters an environment that...

About Us  We’re not like other insurance companies. From our specialty products to our business model, our culture to our results — we’re different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance experience doesn’t just happen. It takes focus and a shared passion for going beyond the expected to forge relationships and deliver care that makes a difference. This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Apply today to make a difference with us.  RLI is a Glassdoor Best Places to Work company with a strong, successful background. For decades, our financial track record has been stellar — a testament to our culture and validation of our reputation as an excellent underwriting company....

ABOUT US At HUB International, we are a team of entrepreneurs. We believe in empowering our clients, and we do so by protecting businesses and individuals in our local communities. We help businesses evaluate their risks and develop solutions tailored to their needs. We believe in empowering our employees. As a global firm, we offer employees resources in both technology and industry expertise, but we still maintain the local flavor of our offices. Our structure enables our teams to maintain their own unique, regional culture while leveraging support and resources from our corporate centers of excellence. HUB is one of the largest global insurance and employee benefits broker, providing a boundaryless array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 20,000 employees in more than 600 offices throughout North America, HUB has grown substantially, in part due to our industry...

The Role: Willis Towers Watson is looking for an energetic individual with growth, pharmacy, clinical, and client-facing expertise to join our growing team. As an Associate Manager, Pharmacy Consulting, you will be at the forefront of managing pharmacy benefits projects for large, complex clients and leverage your experience as a pharmacy benefits expert to make recommendations on plan design and management. You will participate in new business activities and the creation of new intellectual capital. You will position yourself to grow into a consultant role by serving as the pivotal point on all projects and working alongside industry experts on cutting-edge solutions. The ideal candidate is a patient-centric problem solver who possesses the ability to balance client clinical needs and business growth. You will collaborate with a strong team of highly experienced consultants within the practice as well as engage in cross-functional activities.   Responsibilities: Provide...

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  Job Summary The Reinsurance Director provides leadership and oversight for core ceded reinsurance operational activities, ensuring accurate, controlled, and timely reinsurance processing across the department. This role leads a team responsible for reinsurance processing, external reinsurer audits, and captive reinsurance administration, while partnering closely with Reinsurance Operations, Underwriting, Actuarial, Technology, and Accounting/Finance to support financial reporting, operational stability, and data integrity. The Director serves as the business owner for core reinsurance platforms, including ProCede and related applications, with accountability for system availability,...

ABOUT US At HUB International, we are a team of entrepreneurs. We believe in empowering our clients, and we do so by protecting businesses and individuals in our local communities. We help businesses evaluate their risks and develop solutions tailored to their needs. We believe in empowering our employees. As a global firm, we offer employees resources in both technology and industry expertise, but we still maintain the local flavor of our offices. Our structure enables our teams to maintain their own unique, regional culture while leveraging support and resources from our corporate centers of excellence. HUB is one of the largest global insurance and employee benefits broker, providing a boundaryless array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 20,000 employees in more than 600 offices throughout North America, HUB has grown substantially, in part due to our industry...

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:       Chicago, IL :   175 W. Jackson Blvd. 12th Fl. Chicago IL 60604   PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due...

Company Shared Services Argo and Farm Family are specialty property and casualty insurance brands whose underwriting companies are wholly-owned subsidaries of Clearbrook Holdings Inc. Argo and Farm Family partner with agents and brokers to provide insurance solutions that enable businesses to manage risks with confidence. Job Description The Senior Compensation Analyst plays a key role in developing, analyzing, and implementing compensation programs that support the organization's strategic goals and ensure market competitiveness, internal equity, and legal compliance. This role provides expert-level analytics, consultation, and project leadership in the design and administration of base pay, incentive, and recognition programs while also contributing to career architecture initiatives such as job analysis, job architecture frameworks, titling conventions, and market pricing strategies. The ideal candidate brings deep technical expertise in compensation, strong...