459 senior clinical quality analyst jobs found

The Data Capture CERIS Operations Supervisor is responsible for managing daily production for the department, which may include one or more of the following functions:  human resources, customer service, and promoting positive mentorship for the team.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for directing a designated group of employees in their day-to-day operations Accountable for maintaining highest quality of service Handle human resources matters directly related to employees supervised Maintain employee confidence and protect operations by keeping sensitive information confidential May be required to travel overnight to attend meetings May perform daily, weekly and monthly reviews of various reports, invoices, logs and expenses Approve Electronic time cards for employees Assist Manager in establishing employee schedules  Oversee quality control and tracking or error rates Maintaining HIPAA compliance in...

The Closing Team Lead is responsible for monitoring and tracking all closing processes. This role runs queries, maintains reports, and supports the trainers while keeping up with the training material. The Closing Team Lead may assist supervisors with additional projects/tasks. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Run queries to collate data; maintain reports and Excel spreadsheets as needed Monitor and track completion of files and special tasks Oversee the training for all new Closing Analysts Responsible for keeping training material up to date Assist Team of Closing Analysts with questions and escalations Required to close files when needed Serve as a final Quality Control for Closing Analyst files as needed Track analyst errors and create coaching measures Lead meetings and conduct presentations as needed Additional duties as assigned   KNOWLEDGE & SKILLS:...

The CERIS Operations Supervisor is responsible for managing daily production for the department, which may include one or more of the following functions:  human resources, customer service, and promoting positive mentorship for the team. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for directing a designated group of employees in their day-to-day operations Accountable for maintaining highest quality of service Handle human resources matters directly related to employees supervised Maintain employee confidence and protect operations by keeping sensitive information confidential May be required to travel overnight to attend meetings May perform daily, weekly and monthly reviews of various reports, invoices, logs and expenses Approve Electronic time cards for employees Assist Manager in establishing employee schedules  Oversee quality control and tracking or error rates Maintaining HIPAA compliance in all aspects of...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work independently...

The CERIS Operations Supervisor is responsible  for managing daily production for the department, which may include one or more of the following functions:   human resources, customer service, and promoting positive influence over the Analysts. This is an onsite position in Dallas, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Approve Electronic time cards for employees Assist  Manager in establishing employee schedules  Oversee Quality Control and tracking or error rates Maintaining HIPAA compliance in all aspects of communications Requires regular and consistent attendance Oversee production while developing, tracking, and enforcing Quota Track all protocol changes made by clients and communicating those changes with the team Perform timely and accurate employee evaluations Assist manager in the hiring process, help conduct interviews Other duties as assigned by manager   KNOWLEDGE &...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Punctual and consistent attendance required Additional duties as...

- The Senior Support Analyst role combines both analytical and technical skills.   This role is responsible for ensuring the successful ingestion and validation of Bordereau data files from insurance agencies. This role plays a critical part in verifying data layout and schema compliance, analyzing data quality, building and managing data pipelines & data flows to ingest data and designing insightful experience reporting using Power BI. The analyst serves as a key liaison between internal teams and external partners to ensure data integrity and reporting excellence. Key Accountabilities/Deliverables: Engage with insurance agencies to review and validate Bordereau file layouts for ingestion readiness. Confirm data schemas align with internal ingestion requirements and standards. Analyze and validate data fields for completeness, accuracy, and consistency. Build and maintain data pipelines and dataflows within Microsoft Fabric (e.g., Dataflows Gen2, Pipelines)....

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our technology team is currently seeking a Senior Data Engineer to join our growing team in our Worcester, MA office or remote work arrangement. POSITION OVERVIEW: Data engineering is the aspect of data science that focuses on practical applications of data collection and analysis. This role will primarily involve becoming proficient with all internal and external data produced and consumed by THG. This role will be driving larger, more complicated projects independently as well as mentoring less experienced engineers. The Senior Data Engineer will collaborate with business partners and assume a data/tech lead role on cross-functional teams delivering data/reporting solutions. The...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our technology team is currently seeking a Senior Data Engineer to join our growing team in our Worcester, MA office or remote work arrangement. POSITION OVERVIEW: Data engineering is the aspect of data science that focuses on practical applications of data collection and analysis. This role will primarily involve becoming proficient with all internal and external data produced and consumed by THG. This role will be driving larger, more complicated projects independently as well as mentoring less experienced engineers. The Senior Data Engineer will collaborate with business partners and assume a data/tech lead role on cross-functional teams delivering data/reporting solutions. The...

Description Join our US Power team and play a key role in supporting the underwriting of conventional power and renewable energy risks across both operational facilities and construction projects.   We’re looking for a technically strong and commercially minded professional to conduct on-site and desktop risk assessments and provide expert support to our Underwriting and Claims teams. This role is critical in helping evaluate complex power generation and renewable energy risks, enabling informed underwriting decisions and supporting effective claims mitigation strategies.   What you’ll do:   Perform on-site risk engineering surveys and desktop reviews for conventional power and renewable energy risks. Assess operational plants and construction projects, including complex and large-scale exposures. Deliver clear, actionable risk assessments to support accurate and profitable underwriting decisions. Provide technical guidance and...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   ---JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD--- Why Intern with the AAA The Auto Club Group (ACG) The ACG Internship Program aims to provide a rich, relevant, and rewarding experience for college students. Interns will have weekly touch-bases with the Internship Team and meet virtually with executives from around the organization. The goal of the program is to provide interns the opportunity to connect, network, and grow as they work on department-specific projects and is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. In this position on the AAA Carolinas Operations and Sales team, you will: Work on a team supporting the sales of a wide variety of products and...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Position Description (Post for all College Intern Positions) Learn about the Auto Club Group and assigned business line products and services by receiving training through corporate education and/or on-the-job training.  Assignments are based on business line needs, but should encompass professional level work that may include: gathering information, providing analysis and drawing conclusions and/or developing recommendations, conducting department business/system audits, developing reports, performing mathematical calculations for various transactions, selling and servicing of various ACG/affiliated products, etc. Program Components: Must be available during the entire internship period as determined by department Project-focused, with specific group...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   *** This position requires you to reside in the State of Michigan, preferably within the Metro-Detroit Area. In this position you are currently able to work remotely from your home; for day-to-day operations, with occasional "TRAVEL" for meetings (mediation, depositions & more), collaborative activities, or team building activities specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Senior Casualty Litigation Specialist (Michigan) – The Auto Club Group Reports to: Claim Manager II What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking a prospective  Senior   Claim Specialist  to work under less supervision with a high-level of authority. In...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   ---JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD---   Why Intern with the AAA The Auto Club Group (ACG)   The ACG Internship Program aims to provide a rich, relevant, and rewarding experience for college students. The goal of the program is to provide interns the opportunity to connect, network, and grow as they work on department-specific projects and is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization.    In this position with th e AAA ACG Insurance Optimization team you will:   Drive business results by collaboratively developing various dashboards that will provide greater transparency into the health and well-being...

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. Senior State Product Manager – Personal Lines   We are hiring three Senior State Product Manager positions.   1.Senior State Product Manager for California   2.Senior State Product Manager for Maryland,   Delaware   and District of Columbia   3.Senior State Product Manager for Iowa, Minnesota,   Nebraska   and South Dakota   Ideal candidates would   demonstrate :    Strong strategic and critical...

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. Key Responsibilities: Develop and maintain quantitative analytics using advanced statistical, quantitative, or econometric techniques to enhance portfolio risk management and optimize portfolio construction Assist in implementation and delivery of analytics to different areas of risk and investments Perform advanced quantitative analyses and model development, proactively identify emerging risks, and develop tools & applications to enhance the investment and risk management process Research the best industry practice in risk management and portfolio management, develop insightful risk...

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. This role does not qualify for employer sponsored work authorization. Nationwide does not participate in the STEM OPT extension program.   This position can be staffed remotely for potential applicants with critical industry skills and relevant experience. Internal Compensation Grade: G4 #LI-KD1 Position Overview As a Middle Market Actuary at Nationwide, you will play a key role in driving pricing strategy and profitability for our commercial lines products. This position supports actuarial initiatives across middle market segments, a critical area within our P&C business. In this role,...

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. The hired associate must reside within 35 miles of the following location: Columbus: One Nationwide Plaza, Columbus OH, 43215 Work schedule: 3 days in office, 2 days remote. This role does not qualify for employer sponsored work authorization. Nationwide does not participate in the STEM OPT extension program. #LI-SS1 Job Description Summary Nationwide’s vision is to be the most trusted, most caring and most customer-focused protection company. We exist to protect people, businesses and futures with extraordinary care. The Nationwide Investments team manages approximately $130 billion...

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. The hired associate must reside within 35 miles of the following location: Columbus: One Nationwide Plaza, Columbus OH, 43215 Work schedule: 2 days in office, 3 days remote. This role does not qualify for employer sponsored work authorization. Nationwide does not participate in the STEM OPT extension program. #LI-SS1 Job Description Summary Do you have the desire to grow a business and play a critical role in shaping business outcomes? Nationwide has been serving our members and driving business outcomes for almost 100 years. Our industry-leading workforce thrives in an agile work...