policy provisions; accurately enter claim details into the system of record. Maintain electronic claim files for audit.... Communicate effectively and respond timely to TPAs, brokers, policyholders, and internal teams; provide clear updates on claim...
Anticipated End Date: 2026-01-09 Position Title: Claims Auditor I, II & Senior Job Description: Claims Auditor... Auditor Senior is responsible for auditing of high dollar claims across the stop loss business, including complex specialized...
Job Description The Senior Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files.... Identify trends and collaborate with departments to improve claim practices. Support audit reporting and analytics...
and where you can help build a better world of work; think of Gallagher. How you'll make an impact The Pharmacy Auditor... is an integral part of the Pharmacy Audit Team and is responsible for performing and supporting Prescription Drug Claim Audits...
Coding Auditor, Senior Associate who is responsible for performing coding reviews of medical records... and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services...
Coding Auditor, Senior Associate who is responsible for performing coding reviews of medical records... and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services...
and where you can help build a better world of work; think of Gallagher. How you'll make an impact The Pharmacy Auditor... is an integral part of the Pharmacy Audit Team and is responsible for performing and supporting Prescription Drug Claim Audits...
OVERVIEW: This position serves as the in-charge auditor on large, complex and sensitive internal auditing assignments... assignments beyond the normal scope of the audit function. The Senior Lead Investigator handles hotline reports or calls...
to physicians, physician leadership, senior management, Compliance department and staff. CEQAs are required to provide physician... or other certifications: Preferred Educational Requirements: Preferred Experience: Other: Job Specific and Unique Knowledge, Skills...
set by the audit for the auditing concept, for valid claim. identification and documentation (letter writing...). Identifies New Claim Types. Identifies potential claims outside of the concept where additional recoveries may...
participate in auditor assessment, progression process, staffing functions. QA Claim Association/Concepts. Responsible.... Reviews all level auditor claims prior to and after client submission. Set by the audit: for the auditing concept, audit...
participate in auditor assessment, progression process, staffing functions. QA Claim Association/Concepts. Responsible.... Reviews all level auditor claims prior to and after client submission. Set by the audit: for the auditing concept, audit...
. The position reports to the Executive Director, serves in the senior management team, and coordinates with other museum... required materials and oversee annual audit. Serve as the liaison with external auditor and facilitate annual tax return filings. Risk...
improvements and problem solving techniques, changes, and corrective actions directly resulting in major productivity gains, claim... training plans with employees · Works closely with department manager and acts on the behalf of the Senior Mgr...
improvements and problem solving techniques, changes, and corrective actions directly resulting in major productivity gains, claim... training plans with employees · Works closely with department manager and acts on the behalf of the Senior Mgr...