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Audit and Compliance Specialist
1 day ago
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EHS Compliance Specialist
2 weeks ago
Stantec Alpharetta, United StatesEHS Compliance Specialist M ) · Description · Grounded in safety, quality, and ethics, our experts lead their fields and guide our work with rigor, a creative spirit, and vision for growth. We draw from more than 20 technical specialties around the globe and are committed to fost ...
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Safety & Compliance Specialist 2 (Statewide)
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GeorgiaGov Georgia, United StatesUnder supervision, the Building Code Inspector (Safety Fire - Inspections) performs inspections for compliance with policy, procedures, state and federal regulations, and standards to ensure safety and compliance. · Gains knowledge of changes in state, OSHA, NFPA, and other safet ...
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Compliance Service Specialist II
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Wheels Alpharetta, United StatesJob Description: · JOB OVERVIEW · The Compliance Services Specialist II position manages various transactional roles within the Compliance Services team including processing of new vehicle paperwork or annual registration renewals for vehicles managed by Wheels fleet management c ...
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Sr. HR Benefits Specialist
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Quality Assurance Specialist
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Brave Health Georgia, United StatesAbout Us · Brave Health is on a mission to expand access to high-quality, affordable care for behavioral health conditions. We utilize the power of technology to eliminate barriers and expand access to high quality mental health and substance use disorder treatment. Through teleh ...
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Document Reviewer
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Ascendo Resources Georgia, United StatesThis opportunity is open to remote work in the following approved states: AL, AK, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL, PA, TX and WI, in-office and ...
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Sales Operations Specialist
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GSI Sandy Springs, United StatesJob Title: Sales Operations Specialist · An international medical company is hiring a Business Sales Analyst to join its dynamic contracts and sales team. In this role, you will support the sales organization with pricing proposals, predictive spending analysis, and day-to-day ac ...
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Licensing Specialist
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Staff Financial Group Georgia, United StatesOur client, located in Gwinnett County is searching for a Licensing Specialist to join their team. · The Licensing Specialist will support the Legal Department in all licensing matters, including managing license renewals, new applications, modifications and changes from business ...
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Senior Air Quality Engineer
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Montrose Environmental Group Sandy Springs, United States Full timeABOUT YOU · Are you passionate about the environment and ready to join an inclusive workplace, committed to leading new ideas and pathways, and to delivering value? If the answer is, "Yes" then we have an exciting career opportunity for you. · Who are we? We are Montrose, a glob ...
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Consumer Loan Specialist II
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Bank OZK Alpharetta, United States Full time RegularPosition Description: · Job Purpose and Scope: · As the primary point of contact in the consumer loan process, the Consumer Loan Specialist is responsible for educating the applicants(s) on the Bank's loan products and ensuring a complete and compliant loan application. The Con ...
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Construction Management Engineer
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GeorgiaGov Georgia, United StatesTRP051, Transportation Specialist 2 (L) · "Construction Management Engineer (CME)" · Job Salary: $62,000 · Job Specific Duties: Under general supervision, manages highway construction activities in an assigned geographical area or on multiple moderate to highly complex proj ...
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AVP, Corporate Consumer Relations
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MTSS Specialist
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DeKalb County School District Georgia, United StatesMcNair High School is seeking an experienced and professional Multi-Tiered System of Support Specialist (MTSS). · Salary Grade/Schedule: E · Salary Schedules: · The material contained herein is subject to change. All open positions offered by the DeKalb County School District ar ...
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Director, Employee Relations Global
2 days ago
Intuitive Surgical Alpharetta, United States EmployeeCompany Description · At Intuitive, we are united behind our mission: we believe that minimally invasive care is life-enhancing care. Through ingenuity and intelligent technology, we expand the potential of physicians to heal without constraints. · As a pioneer and market leader ...
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Medical Coding Adjunct Instructor
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GeorgiaGov Georgia, United StatesNature of Duties: Under general supervision prepares lesson plans for classroom instruction for credited technical/occupational courses; prepares standardized course syllabi using a provided template; evaluates students' progress in attaining goals and objectives based on establi ...
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Equipment Specialist
1 week ago
BD Sandy, United States Full timeDescription · We are the makers of possible · BD is one of the largest global medical technology companies in the world. Advancing the world of healthTM is our Purpose, and it's no small feat. It takes the imagination and passion of all of us—from design and engineering to the ...
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HR Data Reporting Analyst
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City of Atlanta Georgia, United States Full timeHR Data Reporting Analyst (DPW) · At the City of Atlanta, we are passionate about building and improving our community. Our police officers, firefighters and building inspectors keep our citizens safe. Our Public Works staff keeps our City clean and helps maintain, build, and imp ...
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Sr. Client Service
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ADP Alpharetta, United StatesADP is hiring a Sr. Client Service & Product Support Specialist · In this role, you will be responsible for servicing Wisely Accounts and Distribution clients within Wage · Payments in a call center environment. You will be providing support on client day-to-day operations and ...
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Client Service Associate
1 week ago
Hub International Sandy, United StatesAbout HUB: · HUB is the 5th largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 18,000 employees in 600 offices ...
Claims Quality Assurance and Compliance Specialist - Alpharetta, United States - Westfield
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Description
Job DescriptionWe are seeking a detail-oriented and analytical individual to join our team as a Specialty Claims Quality Assurance and Compliance Specialist.
The ideal candidate will possess strong analytical skills, attention to detail, and a comprehensive understanding of Specialty insurance claims best practices, procedures and compliance regulations.
ResponsibilitiesWhat you will do:
Assist in the implementation of a QA platform for auditing, reporting and the tracking of action plans. Review Specialty insurance claims documentation and processes to ensure accuracy, completeness, and compliance with established standards and best practices. Conduct audits and analysis of claims data to identify trends, discrepancies, and areas for improvement. Collaborate with cross-functional teams to resolve quality issues. Develop and deliver compliance training programs for claims processing staff on regulatory requirements and best practices. Stay informed about changes in regulatory requirements, industry trends, and best practices. Ensure internal claims adjusters are properly licensed. Prepare comprehensive reports on quality assurance and compliance activities, highlighting areas for improvement and compliance status. Identify opportunities for process optimization and efficiency gains within claims processing workflows.
QualificationsWhat you need to have:
Five to seven years of experience in insurance claims management, compliance, or similar role within insurance. Strong knowledge of specialty lines of insurance, insurance regulations, and relevant state and federal laws. Strong analytical skills with the ability to interpret complex data and identify trends. Attention to detail and accuracy in documentation and analysis. Proficiency in Microsoft Office Suite and claims process software. Exceptional communication and interpersonal skills, with the ability to collaborate effectively across departments. Professional certification in insurance, compliance, or a related field is preferred. Ability and willingness to travel as needed.#wsp