8 clinical review auditor jobs found

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary responsibility is evaluating claim handling quality, accuracy, and timeliness in categories including but not limited to: coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. This role has the ability to interpret results and trends in order to deliver operational reporting, and participate in the development and presentation of training.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Model ethical behavior and executes job responsibilities in accordance with CorVel’s core values, ethics, and information protection policies Serve as technical QA lead to assigned offices or departments Lead QA projects and serve as primary coordinator for senior leadership of assigned offices Support the...

As the Life Waiver of Premium Claims Specialist for FPRS (Financial Protection and Retirement Solutions) , you will play a key role in delivering meaningful experiences that support growth—both for your career and for our team’s collective future. At Guardian, we live our Purpose every day. As champions of wellbeing for ourselves, our communities, and our consumers, we work together to turn what’s possible into reality. We believe in your aspirations for purpose, leadership, and achievement in both your professional and personal life, and this role provides the opportunity to bring those aspirations to life. We will help build the core competencies you will need to be a successful Life Waiver of Premium Claims Specialist. In your first year, we will provide extensive training in a highly supportive environment. If you have an internal drive to investigate using your critical thinking skills, assessing policy matters, and can manage competing priorities while meeting deadlines,...

As a Claims Coordinator for FPRS (Financial Protection and Retirement Solutions), you will play a key role in delivering meaningful customer experiences that support growth—both for your career and for our team’s collective future. At Guardian, we live our Purpose every day. As champions of wellbeing for ourselves, our communities, and our consumers, we work together to turn   what’s   possible into reality. We believe in your aspirations for purpose, development, and achievement in both your professional and personal life, and this role   provides   the opportunity to b ring those aspirations to life.     We will help build the core competencies you will need to be successful as a Claims Coordinator. In your first year, we will provide extensive training in a highly supportive environment. If you enjoy working directly with customers,   gathering   and   validating   information, navigating multiple systems, and managing competing priorities while...

The Technical Product Owner/ Engineer supports strategic modernization initiatives within the Financial Protection and Retirement Services Technology organization. The role partners closely with engineering teams to translate business needs into clear technical specifications, features, and system designs. This individual contributes hands‑on to technical discussions, solution design, and implementation support to ensure high‑quality delivery. This individual collaborates with product managers, business partners, and cross‑functional technical teams to shape technical solution. Strong knowledge of Agile is required to manage the backlog and drive iterative development. The individual will be deeply involved in hands-on technical activities such as development, supporting design decisions, creating technical requirements, and ensuring high‑quality implementation. You Are A self-starter, continuous learner and hands-on technical engineer who can translate vision from the...

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 Premium Audit Supervisor Job Description The Premium Audit Supervisor is responsible for overseeing the day-to-day operations of the premium audit team, ensuring timely, accurate, and compliant audits of policyholders.  This role supervises audit staff, including analysts and coordinators, manages workflow, ensures quality control, and provides training and support to direct reports. This position reports to the Premium Audit Manager. The supervisor plays a critical role in maintaining audit standards and fostering team development while helping the audit department meet their goals. The primary duties and responsibilities of...

Job Responsibilities and Requirements The Senior HR Operations Analyst is a key member of the Total Rewards and HR Operations team and plays a critical role in supporting effective, scalable, and compliant HR service delivery. This role partners closely with HR Operations leadership and HR functional teams to translate business needs, policies, and HR strategy into clear operational processes, system solutions, and actionable insights. HR Operations Execution & Process Enablement Partners with HR Operations manager to implement, maintain, and continuously improve HR operational processes that support consistent, efficient, and compliant HR service delivery. Leads the annual review, update, and organization-wide distribution of the Employee Handbook in partnership with HR leadership, Legal, and other stakeholders. Develops and maintains HR procedures, reference guides, and job aids that translate policies and system functionality into clear, actionable guidance for...

The Wealth Management Operations Support role is responsible for overseeing and optimizing daily operations to support our field force. This position plays a critical role in planning capacity, improving workflows, supporting the operations team, and partnering with firm leaders to drive efficiency and service quality. You will be responsible for, but not limited to, broad operational administration, covering grey areas, workflows, and relationship management for our field force. You excel in a dynamic and fast-paced environment and have the ability to create relationships with senior leaders across firms we partner with. You will Lead capacity planning for our Guardian India operations partners Oversee and manage all broker-dealer operations work queues Own and maintain the operations training curriculum in partnership with our Training & Development Team Partner with Third-Party platform owners on operational support and optimization Design, implement, and...

Would you like to take ownership in a dynamic, high-growth business that truly walks the talk? Oswald Companies seeks goal-driven professionals ready to take their career to the next level. Job Summary The Client Manager will be responsible for providing quality client management of client relationships by anticipating client needs and questions, performing research to ensure the client’s employee benefits program supports their financial and organizational goals, and providing renewal management with oversight, guidance, and input from other senior members of the team. This also includes growth on the current book of business, an understanding of the client’s business, and a minimum of 95% retention and client satisfaction rating. Essential Functions Quality, Client Service & Expertise Proficiently manage the client service cycle, monitor time frames and meet renewal deadlines. With oversight, guidance and input from the CE/Producer: Participate in annual...