SIU Case Manager USAASIU Case ManagerPhoenix, AZ$85,040–$162,550 / yearReviews investigative findings of claims identified as having confirmed elements of fraud, concealment, misrepresentation, or intentional act by evaluating the evidence to determine transfer or appropriation of claims disposition. As a dedicated SIU case manager, within defined guidelines and framework you will evaluate and conclude claims identified by SIU Investigators as having elements of fraud or an intentional act.
Claims Examiner Arizona Priority CareClaims ExaminerChandler, AZ$21–$23 / hourArizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. This individual works both independently and in conjunction with internal customers to adjudicate claims and responds to provider or client inquiries in an accurate, timely and courteous manner.
Claims Examiner II W. R. Berkley CorpClaims Examiner IIScottsdale, AZProactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices. The Claims Examiner I's primary job function includes efficiently and effectively handling primarily basic third-party general liability losses in a "paperless" environment.
Claims Examiner I BerkleyClaims Examiner IScottsdale, ArizonaProactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices. The Claims Examiner I’s primary job function includes efficiently and effectively handling primarily basic third-party general liability losses in a “paperless” environment.
Claims Examiner II BerkleyClaims Examiner IIScottsdale, ArizonaProactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices. The Claims Examiner I’s primary job function includes efficiently and effectively handling primarily basic third-party general liability losses in a “paperless” environment.
Senior Claims Examiner, Management Liability, Markel Group IncSenior Claims Examiner, Management Liability,Scottsdale, AZ$78,000–$107,250 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct, and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist internal claims vendor management, disbursement and legal collections teams with defense counsel, bill payment, and collection issues.
Senior Disability Claims Examiner (LTD) (Virtual) Prudential Financial IncSenior Disability Claims Examiner (LTD) (Virtual)Scottsdale, AZRemote$61,700–$101,900 / yearThe Long-Term Disability (LTD) Senior Disability Claims Examiner is responsible for providing excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims. Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication.
Senior Claims Examiner, Medical & Healthcare Claims Markel Group IncSenior Claims Examiner, Medical & Healthcare ClaimsScottsdale, AZThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders.
Claims Examiner - Federal Workers' Compensation American International Group Inc (AIG)Claims Examiner - Federal Workers' CompensationScottsdale, AZMake your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Reimagining insurance to make a bigger difference to the world American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the worlds most far-reaching property casualty networks.
Claims Examiner II, Lawyers and Financial Advisors Markel Group IncClaims Examiner II, Lawyers and Financial AdvisorsScottsdale, AZThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Claims Examiner, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.Claims Examiner, Auto | Bodily InjuryAZTo analyze complex auto bodily injury claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements. Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
LTD Claims Examiner II Reliance Standard Life Insurance CompanyLTD Claims Examiner IIPhoenix, ArizonaRemoteReviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions.
Senior Claims Examiner Amtrust Financial Services IncSenior Claims ExaminerScottsdale, AZ$87,600–$112,000 / yearResponsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process. 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 the role, as well as market and business considerations.
Claims Examiner - Subrogation Claims Auto-Owners Insurance GroupClaims Examiner - Subrogation ClaimsMesa, AZOur group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success.
LTD Claims Examiner II Matrix Absence Management, Inc.LTD Claims Examiner IIPhoenix, AZRemote$52,450–$65,570 / yearReviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions.
Claims Examiner 4 Swift Transportation Co LLCClaims Examiner 4Phoenix, AZVolunteer opportunities to support our local communities- We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back. Diversity, Equity and Inclusion - A diverse workforce allows us to achieve a dynamic business advantage where we can openly collaborate, thus bringing new ideas to the table that contribute to innovative and effective solutions.
Claims Examiner, Medical Stop Loss Crum & Forster Holdings Corp.Claims Examiner, Medical Stop LossPhoenix, AZRemoteSalary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community.
Senior Examiner, Personal Umbrella Claims GEICO GENERAL INSURANCE COMPANYSenior Examiner, Personal Umbrella ClaimsTucson, AZ$65,600–$129,150 / yearWe are looking for claims professionals who can thrive in a fast-paced environment, are eager to develop as a claim examiner and play a critical role in investigating, evaluating and resolving excess claims. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
Lead Claim Examiner I Amtrust Financial Services IncLead Claim Examiner IScottsdale, AZ$66,900–$93,000 / yearCommunicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans. 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 the role, as well as market and business considerations.
Workers Compensation Lead Claim Examiner I AmTrust Financial Services, Inc.Workers Compensation Lead Claim Examiner IScottsdale, Arizona$75,000–$93,000 / yearOverview: The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.
Senior Auto Claim Examiner Chubb LtdSenior Auto Claim ExaminerPhoenix, AZThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Knowledge, Skills and Abilities: High level of expertise in all aspects of claims adjusting to include total loss handling and total loss salvage/compliance requirements.
Claims Coordinator Arizona Priority CareClaims CoordinatorChandler, Arizona$19–$21 / hourAs detailed below, primary responsibilities of the Claims Coordinator will include: documenting, analyzing and transmitting all medical documents received to the appropriate departments; assisting with inbound provider phone calls; respond to emails from internal departments regarding claims issues while collaborating with the claims examiners to resolve issues, and communicate resolutions to providers and/or internal departments. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.
Senior Claims Specialist, Cyber Markel Group IncSenior Claims Specialist, CyberScottsdale, AZThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. • Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Claims Support Specialist, Medical Stop Loss Hybrid Crum & Forster Holdings Corp.Claims Support Specialist, Medical Stop Loss HybridScottsdale, AZRemoteWe believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community. Information about the Role, Line of Business and Team: The role of Claims Support Specialist is a unique opportunity to work with a high-quality team of leaders and benefit from the security and stability of a large organization while maintaining a nimble and responsive approach to business.
Claims Support Specialist, Medical Stop Loss - Hybrid Crum & ForsterClaims Support Specialist, Medical Stop Loss - HybridScottsdale, ArizonaRemoteWe believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistAZRemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Senior Environmental Technical Claims Specialist Argo Group International Holdings IncSenior Environmental Technical Claims SpecialistAZ$99,200–$118,100 / yearAlternatively, we are also open to consider candidates working from home anywhere in the continental United States This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial environmental claims (mostly complex storage tank claims) and contributing to providing superb results for our clients. Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C.
Claims Oversight & Compliance Manager Arizona Priority CareClaims Oversight & Compliance ManagerChandler, ArizonaAs a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost. Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models.
Senior Claims Manager W. R. Berkley CorpSenior Claims ManagerScottsdale, AZAs an elite Excess and Surplus Lines market, Nautilus Insurance Group offers commercial property and casualty insurance solutions to appointed wholesale surplus lines producers countrywide. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Claims Manager BerkleyClaims ManagerScottsdale, ArizonaThe actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Facilitates and promotes consistent, positive Department financial results by actively strategizing with and providing appropriate guidance and authority to technical staff.
Senior Claims Specialist - WA and OR Jurisdiction Experience Liberty Mutual Holding Company IncSenior Claims Specialist - WA and OR Jurisdiction ExperienceChandler, AZResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss.
Claims SIU Specialist Turo IncClaims SIU SpecialistArizona, AZ$53,000–$66,000 / yearReview and investigate claims identified through automated risk models, internal referrals, vendor referrals, NICB alerts, law enforcement requests, and other investigative sources to identify fraud indicators and potential loss prevention opportunities. Conduct investigations involving suspected fraud, material misrepresentation, policy violations, and other SIU-related concerns, including gathering evidence, conducting interviews, analyzing claim documentation, and determining appropriate investigative outcomes.
Senior Claims Specialist I, Workers Compensation - West Region Liberty Mutual Holding Company IncSenior Claims Specialist I, Workers Compensation - West RegionChandler, AZRemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the states tort laws as normally acquired through a bachelors degree (or equivalent training) plus 3 to 5 years directly related work experience.
Claims Specialist II, Workers Compensation - West Region Liberty Mutual Holding Company IncClaims Specialist II, Workers Compensation - West RegionChandler, AZRemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements, and managing an inventory of commercial property/casualty claims involving bodily injury or property loss.
Claims Processor Turo IncClaims ProcessorArizona, AZIn general, Turo interacts with candidates through our Careers page and via turo.com email addresses, and we don't ask candidates for sensitive financial or personal info or request money as part of the hiring process (so an application fee or equipment costs). Whether you're flying in from afar or looking for a car down the street, searching for a rugged truck or something smooth and swanky, Turo puts you in the driver's seat of an extraordinary selection of cars shared by local hosts.
Mgr - IT Business Medicaid Claims Services - Hybrid Blue Cross and Blue Shield AssociationMgr - IT Business Medicaid Claims Services - HybridPhoenix, AZWork effectively with management, product owners, scrummasters, business analysts, developers, technical leader, architects, system administrators, and testers, design, and deliver successful software solutions. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
EDI Technical Analyst (Claims) - Hybrid Blue Cross and Blue Shield AssociationEDI Technical Analyst (Claims) - HybridPhoenix, AZDevelops technical documentation, designs, analyzes, tests, provides end user support and training for new applications and data structures; and provides post-implementation review for systems and reporting to support customers and management. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Appeal Examiner- Meritain Health CVS Health CorpAppeal Examiner- Meritain HealthWork At Home, AZ$17–$31.30 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
Examiner Nurse Practitioner Loyal Source Government Services LLCExaminer Nurse PractitionerPeoria, AZ$138,923–$168,923 / yearThe role involves reviewing the claim, performing focused assessments of claimed injuries, reviewing medical records, and potentially rendering a medical opinion based on the record review and completed Compensation & Pension (C&P) exam. Job Responsibilities: Conduct Comprehensive Medical Disability Examinations: Perform thorough and focused medical evaluations of Veterans, including reviewing their medical history, conducting physical examinations, and assessing the impact of disabilities on their daily life and functional abilities.
EDI Technical Analyst (Claims) - Hybrid Blue Cross Blue Shield of ArizonaEDI Technical Analyst (Claims) - HybridPhoenix, ArizonaDevelops technical documentation, designs, analyzes, tests, provides end user support and training for new applications and data structures; and provides post-implementation review for systems and reporting to support customers and management. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Injury Examiner USAAInjury ExaminerPhoenix, AZ$85,040–$162,550 / yearAs a dedicated Injury Examiner, you will be responsible to adjust complex auto and homeowner bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
Auto Claim Specialist Chubb LtdAuto Claim SpecialistPhoenix, AZThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Position Overview: The Claim Specialist (Commercial) is responsible for handling Commercial Auto Claims, including property damage, property damage liability, rental management, and other applicable coverages.
Member and Veteran Liaison Coordinator - Remote in AZ Blue Cross and Blue Shield AssociationMember and Veteran Liaison Coordinator - Remote in AZPhoenix, AZRemoteKey responsibilities include working directly with members and families to identify concerns and remove barriers that affect service delivery or member satisfaction, educating members and communities on the availability of resources, building partnerships with providers, community-based organizations, and key stakeholders, and assessing services with the use of stratified data and outcome measures. Collaborate with AHCCCS, the AHCCCS-Approved Statewide Veteran Resource Provider, Veterans Affairs, key stakeholders, and community organizations to provide care and support for service members, veterans, and families.
Examiner Physician Assistant Loyal Source Government Services LLCExaminer Physician AssistantTucson, AZ$132,891–$162,891 / yearThe role involves reviewing the claim, performing focused assessments of claimed injuries, reviewing medical records, and potentially rendering a medical opinion based on the record review and completed Compensation & Pension (C&P) exam. About Loyal Source Loyal Source is an Orlando-based workforce solutions provider dedicated to delivering elite services worldwide, with a focus in government healthcare, technical and support services, engineering, and travel healthcare.
Dental Insurance Claim Processor Comfort Dental East MesaDental Insurance Claim ProcessorMesa, AZFull timePrimary Duties Include: • Preparing and electronically submitting dental insurance claims promptly and accurately, including pre-authorizations, narratives, and supporting documentation. • Monitoring outstanding claims, generating aging reports, following up with insurance carriers on delays/denials, and pursuing appeals to recover maximum reimbursements.
Technical Training Lead Representative - Cigna Healthcare - Remote The Cigna GroupTechnical Training Lead Representative - Cigna Healthcare - RemoteArizona Work at Home, AZRemote$22–$33 / hourWhile training new claims examiners, fulfill all claims examiner functions as listed below: Ensures accurate and complete claims processing by verifying required documentation, collaborating with relevant parties to obtain necessary information, and confirming system adjudication aligns with plan provisions. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Sr. Compliance Specialist - Payment Integrity ValenzSr. Compliance Specialist - Payment IntegrityPhoenix, ArizonaRemoteInterpret, analyze, and operationalize applicable regulatory requirements, including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA) laws, CMS requirements, and state Department of Insurance (DOI) regulations impacting payment and billing practices. Vlenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience.
Fraud, Waste & Abuse (FWA) Investigator - No Surprises Act (NSA) CVS Health CorpFraud, Waste & Abuse (FWA) Investigator - No Surprises Act (NSA)Work At Home, AZ$66,330–$145,860 / yearThe position plays a key role in identifying fraud risks, supporting program integrity efforts, and helping to prevent financial losses related to fraud, waste, and abuse. Directs complex investigations, including data analysis, interviews, and document review, to identify potential fraud, waste, and abuse, including NSA-related activity.
Auditor/Investigator I Qlarant Quality Solutions IncAuditor/Investigator IAZCollects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs.