18 clinical review auditor jobs found

MSIG USA continues to grow!  Company Overview: MSIG USA is the US-based subsidiary of  MS&AD Insurance Group Holdings, Inc. , one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. The Trade Credit & Political Risk Claims Manager plays a critical role in safeguarding the company’s financial stability and reputation by overseeing the end‑to‑end claims process for trade credit and political risk lines of business. This leader ensures fair, timely, and strategic claims resolutions while maintaining strong relationships with insureds, brokers, reinsurers, and internal stakeholders. Key Responsibilities Claims Management Lead the investigation, evaluation, and resolution of complex...

 LOCATION: Hybrid, Melville, NY    Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in San Francisco and founded in 2007, our company has over 3,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in...

Description Summary: The Managing Director - Warehouse Lending for CSG - Corporate Mortgage Finance Group, will be an integral component to the building out of the Corporate Mortgage Finance Group vertical for Huntington Bank and will serve as a point person in determining the customer’s needs, meeting them through the seamless delivery of the bank's products, services and associated resources.  You will manage an assigned team of Relationship Manager/Bankers as direct reports; personally originate, service and maintain an assigned Commercial Loan Portfolio within the Corporate Mortgage Finance Group; work collaboratively with the group’s Banker/RMs, Portfolio Managers and other internal colleagues to support current and prospective client relationship growth. This position reports to the Head of CMFG, or another senior leader determined by the Head of the group.  In this role, you will be performing the...

Overview The Senior Treasury Analyst reports to the Vice President of Treasury and provides reporting, analysis, and operational oversight across key Treasury functions including Global Bank Services, Liquidity & Collateral Management, Bank Relationship Management, Credit Risk and FX. The role requires strong execution of daily treasury activities while upholding AmTrust’s organizational mission, values, and standards.   This position will be hybrid (Monday - Thursday in office, Friday remote) and can be worked in either our Jersey City, NJ or Manhattan (Financial District), NY office.    The expected salary range for this role is $80,000 - 95,000.   Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of...

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! 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. It is our intention to fill this role in Des Moines, Iowa or Columbus, Ohio. However, remote applicants who bring critical industry skills and relevant experience may be considered. Serve as a strategic liaison between business stakeholders and line-of-business pricing teams. This role is instrumental in advancing pricing strategy by translating complex technical analyses into actionable insights that guide business decision-making. The ideal candidate will bridge the gap between actuarial expertise and business execution, ensuring pricing recommendations are aligned with organizational goals....

Position Title Commercial & Private Bank Compliance Risk & Controls Associate Location New York, NY 10018 Job Summary The Commercial & Private Bank Compliance Risk & Controls Associate will play an integral role in the design, buildout, transformation and implementation of a Compliance risk management framework as well as advise and oversee business lines through ongoing identification, assessment, and measurement of material risks and key controls. The Commercial & Private Bank Compliance Risk & Controls Associate, in this 1st Line of Defense (1LOD) role, will bring expertise in regulatory Compliance and risk experience in Commercial & Private Banking businesses. • The Private Bank consists of Private Client Groups (PCGs) who are highly specialized in providing white glove service to High Net Worth and Commercial clients by offering Deposit products, lending, and products and services from Flagstar’s broader offerings. • The Commercial Bank...

Position Title Director - Internal Audit Location New York, NY 10018 Job Summary The Audit Director plays a crucial role in assuring the financial integrity and operational effectiveness of the `bank working closely with senior management of the bank and overseeing a team of audit professionals. This role is a leader in the company applying critical thinking to identify key risks and value-added feedback that can lead to risk reduction in the company. This key leader also cultivates a positive and ethical work environment and encourages the professional development of the team. The Director of Internal Audit serves as the "Engagement Owner" (EO) responsible for overseeing a select book of business. Oversees and directs the execution of audits to ensure operational efficiency in fieldwork, consistency of methodology, and proper documentation of workpapers. Works closely with the Senior Audit Leadership team assisting in strategic initiatives within the Internal Audit...

We’re thrilled that you are interested in joining us here at the Amynta Group! Provide oversight and work closely with the claims team handling general liability and auto liability losses. In this role you will ensure that claims are handled efficiently and timely, while maintaining a high level of customer satisfaction. This role is critical in understanding complex coverage issues and managing complex claims. Oversee carrier and TPA adjusters on the evaluation and adjudication of insurance claims. Analyze, discuss, and collaborate on large losses to ensure accurate and timely posting of loss reserves Review complex lawsuits for coverage and review coverage letters for accuracy Develop procedures to improve claims processing efficiency and ensure compliance Provide claim guidance and instruction to TPA’s and adjusters to ensure a high level of claims handling Develop strategies to improve claims handling and oversee the adequacy of indemnity and expense...

The Supervisory Accountant is integral in supporting AIG’s General Insurance International Controllership team, with primary responsibility for controllership activities related to the preparation and analysis of quarterly consolidated financial statements for the General Insurance International operating segment in accordance with US GAAP and internal policies.  This position is responsible for supporting delivery of consolidated financial information included within the AIG 10-Q/10-K, maintaining data integrity and a robust control environment to provide effective support to the General Insurance International Controllership.  This role will also involve partnering with other stakeholders to build strong relationships and collaborate across various functions of the Company, to support an efficient close process. Key Responsibilities: Preparing quarterly consolidated financial statements for AIG General Insurance International’s results based on regional submissions, in...

Consultant Claims - CH08CE Specialist Claims - CH07DE Specialist Claims CA - CH07DN Consultant Claims CA - CH08BN 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.           This position can be filled at either the Consultant or Specialist level, based on the candidate’s experience.  The Claim Specialist and Claim Consultant roles are advanced claim handler positions within the ENVIRONMENTAL unit of The Hartford’s Complex Claims Unit (CCU), responsible for the management of various complex claims brought against The Hartford’s insureds.  Claims in CCU are often associated with complex fact patterns and coverage issues that may involve multiple years and types of insurance coverage. CCU claims also commonly involve...

Position Title Quantitative Model Risk Analyst Location Hicksville, NY 11801 Job Summary Pay Range: 59- 106K The Quantitative Model Risk Analyst supports the implementation and execution of the Bank-wide model risk management policy. This includes the review of complex models used within the organization, model development documentations, model code, and model performance. The Quantitative Model Risk Analyst prepares written validation reports, makes recommendations, and follows up and tracks ongoing model risk issues. Pay Range: Local Minimum Wage - $0.00 - $0.00 Job Responsibilities: JOB RESPONSIBILITIES Performs independent validation of selected models to assess the conceptual soundness of model design and development, ongoing monitoring, and outcomes analysis. Replicates the model code, reviews model development documentation and model inputs, processing, and outputs. Develops and maintains effective partnerships with analysts, model owners,...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has a need for Clinical Review Nurse remote or in an office  location.     PRIMARY PURPOSE:   The Clinical Review nurse has the responsibility of reviewing the medical necessity, appropriateness, quality and efficiency of services in the appropriate setting for Workers’ Compensation claimants. This position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the AmTrust Claims Adjuster team to expedite medically necessary treatment for each claim.  They also review pharmacy authorizations to determine appropriateness of pharmaceutical treatment.  Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.   This position will be hybrid out of one of our AmTrust office locations!  Responsibilities...

Position Title Check Operations Specialist Location Hicksville, NY 11801 Job Summary The Check Operations Specialist for Item Processing is responsible for ensuring the accuracy, compliance, and timely processing of check-related transactions and remittances. This role supports critical operational functions including data validation, exception handling, and customer adjustments. Pay Range: $18.58 - $23.00 Pay Range: Local Minimum Wage - $0.00 - $0.00 Job Responsibilities: File Review and Data Accuracy Review and correct incoming check file data to ensure accuracy and completeness prior to processing  Identify and resolve discrepancies Ensure timely handling to minimize customer impact and regulatory risk Account and Transaction Reconciliation Perform daily reconciliations of general ledger transactions to ensure timely resolution of exceptions Monitor and resolve rejects, exceptions, and outstanding items within set timelines Participate in end-of-day...

   Job Summary : The Claims Casualty Manager oversees a team of claims adjusters and manages complex claims for a variety of policies, including general liability, homeowners, and business owners’ policies. This role is responsible for managing the claims process from start to finish, ensuring policy interpretation and coverage analysis, setting claim reserves, and working to achieve timely and cost-effective resolutions. They also conduct data analysis to identify trends, provide insights to other departments, and ensure compliance with legal and regulatory requirements. Reports to : Vice President of Claims Duties and Responsibilities Include (but not limited to) : · Manage the entire claims process, from initial notification to final resolution, while ensuring the team follows best practices. · Provide direction and technical expertise to claims adjusters, especially for complex or litigated cases. · Analyze and interpret insurance policies to determine...

Primary Details Time Type: Full time Worker Type: Employee The Opportunity: The purpose of the AVP, Internal Audit Manager is to manage audits, ensuring that the work performed by the audit team is delivered within agreed timelines and to a high standard. They will also lead more complex audits, managed by a VP, Senior Internal Audit Manager. They may be assigned direct reports to manage their performance and support their career development. Location: New York City, New York Work Arrangement: This role is hybrid, where you will be expected to be in the office 2-3 days per week. The salary range for this role is: $166,000 -$249,000 Your New Role: Audit execution  Manage audits “end to end” ensuring that the work performed by the audit team is delivered within agreed timelines and to a high standard.  Review key deliverables and working papers, raising coaching notes where necessary.  For more complex audits, lead audit engagements,...

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.  The...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  Independence American Insurance Company (IAIC) , a subsidiary of IPH, has over 50 years of underwriting experience and a history of innovation in the pet insurance industry. IAIC has built a reputation as a trusted and dependable partner. We are a pet-focused underwriter with deep insurance industry...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  Independence American Insurance Company (IAIC) , a subsidiary of IPH, has over 50 years of underwriting experience and a history of innovation in the pet insurance industry. IAIC has built a reputation as a trusted and dependable partner. We are a pet-focused underwriter with deep insurance industry...