29 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 Disability Clinical Specialist PRIMARY PURPOSE : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with providers and employees by providing case direction and ensures medical information substantiates the need for employee absence from work.  ESSENTIAL FUNCTIONS and RESPONSIBILITIES Performs standard clinical reviews of referred medical claims based on client...

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,...

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,...

About Us: EquiTrust Life Insurance Company is a national carrier of competitive, client-friendly annuity products sold through a variety of distribution channels, including more than 20,000 independent agents and independent marketing organizations (IMOs). Since 2003, we have provided exceptional customer service to our clients by operating with integrity and passion. Our efforts are supported by a dedicated workforce who execute their responsibilities through teamwork and an entrepreneurial spirit. EquiTrust sells products nationwide and is headquartered in Chicago, Illinois, with operations in West Des Moines, How You'll Contribute As a Policy Administration Data and Analytics Manager, you will lead the reporting, analytics, and performance insights function within Policy Administration. You will be responsible for overseeing a team of data and analytics professionals, developing reporting strategies, ensuring data accuracy and governance, and delivering actionable...

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 - French Canadian Bilingual French Canadian Speaking Required 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;...

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. Disability Representative ADA   Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence: Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 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...

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,...

UFG is currently hiring for a Staff Accountant to assist with accurate accounting, reporting and analysis of United Fire Group’s (UFG) financial transactions. This role prepares supporting documents and performs procedures to ensure all transactions are properly recorded in accordance with GAAP and statutory accounting principles while maintaining data integrity across subledger and financial reporting systems. Working closely with other members of the Financial Reporting team, the Staff Accountant provides support for the month-end and quarter-end close processes, ensuring accurate and timely financial reporting across multiple company entities. This individual also assists in implementing process improvements, strengthening internal controls, and supporting both external and internal audit requests. The ideal candidate demonstrates strong technical accounting skills, attention to detail, analytical skills and the ability to work both independently and collaboratively in a...

Primary Details Time Type: Full time Worker Type: Employee Title: Senior Claims Adjuster - Crop  The Opportunity: The purpose of this role is to provide efficient and precise claims services to policyholders and agents through field inspections, communication with stakeholders, investigations, adjustments, and policy administration while ensuring adherence to regulatory requirements. Location: Work Remotely Iowa, USA Work Arrangement: This role is fully remote; approximately 20% home office work and 80% field work. The salary range for this role is between $64,000-$95,000   Your new role    Complete field inspections, reviews and adjustments accurately and efficiently to administer crop insurance policies. Ensure compliance with insurance statutes and regulations to apply crop policies cost-effectively. Build and maintain customer relationships through timely and accurate policy service. Document and process loss...

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 ADA Accommodation Coordinator 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...

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,...

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,...

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.   DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all....

UFG is currently hiring a Senior Reinsurance Underwriting Manager who is responsible for leading a team of Reinsurance Underwriters while directly managing a profitable book of U.S. reinsurance business, ensuring disciplined risk selection, pricing, and portfolio performance in line with company strategy and underwriting standards. The ideal candidate is collaborative by nature and possesses a strong grasp of industry business practices, with the ability to build and maintain senior-level relationships with brokers and ceding companies. The Assumed Reinsurance business is a key component in our strategy to grow and create economic value.  The team supporting assumed reinsurance is comprised of senior leaders and experienced professionals acting together to selectively underwrite business that offers a material contribution toward our corporate performance goals. Essential Duties and Responsibilities:   Lead, coach, and develop a team of Reinsurance...

Company Details "Our Company provides a state of predictability which allows brokers and agents to act with confidence."   Founded in 1967, W. R. Berkley Corporation has grown from a small investment management firm into one of the largest commercial lines property and casualty insurers in the United States.   Along the way, we’ve been listed on the New York Stock Exchange, become a Fortune 500 Company, joined the S&P 500, and seen our gross written premiums exceed $10 billion.   Today the Berkley brand comprises more than 50 businesses worldwide and is divided into two segments:  Insurance and Reinsurance and Monoline Excess.  Led by our Executive Chairman, founder and largest shareholder, William. R. Berkley and our President and Chief Executive Officer, W. Robert Berkley, Jr., W.R. Berkley Corporation is well-positioned to respond to opportunities for future growth.   The Company is an equal employment opportunity employer....

UFG is currently seeking an  AVP, Major Claims Leader who is responsible for the strategic direction, operational leadership, and technical excellence of the organization’s most complex and high-exposure claims. This role oversees a diverse portfolio including complex products liability, class actions, coverage litigation, complex construction defect claims, excess and surplus lines, general liability and commercial auto litigation. Reporting directly to the VP of Corporate Technical Claims, this role serves as a key technical and leadership authority within the claim’s organization, providing executive-level guidance on claim strategy, reserving, litigation management, risk transfer, and resolution of high-severity matters. The role operates in a highly collaborative environment, partnering with the VP of Corporate Technical Claims on enterprise-level initiatives involving: Legal, Underwriting, Actuarial, Reinsurance, and external counsel to drive consistent, predictable,...

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 - French Canadian Bilingual French Speaking Required 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...

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 our center of excellence in Dubuque, Iowa. 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...

UFG is currently seeking a Manager, Reinsurance Accounting to be responsible for overseeing the day-to-day accounting operations, reporting, analysis and compliance of the Company’s reinsurance activities. This role directs the procedures performed by the team to ensure the completeness, accuracy, and timeliness of all reinsurance accounting processes, including ceded and/or assumed transactions, integrity of calculations, reconciliations, and financial disclosures. Working closely with Finance leadership, Actuarial, and Reinsurance Operations teams, this position provides technical research and other accounting support for treaty execution activities, cash settlements, and reinsurance reporting (GAAP and statutory) processes while maintaining an effective internal control environment. The Manager will play a key role in continuous improvement, driving process optimization, ensuring regulatory compliance, and contributing to the modernization of reinsurance accounting...

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 Field Adjuster ***5+ years of continuous property insurance adjusting experience involving complex loss valuation and scope analysis (homeowners & commercial property.*** PRIMARY PURPOSE :  Appraisal Assignment Execution •    Review claim files assigned to appraisal to understand the dispute parameters and valuation issues in scope. •    Perform loss inspections as necessary to evaluate disputed damages, including measurements, photo documentation, and...