Claims Specialist Jobs in Richmond, VA

Lead and optimize prepayment claims auditing programs, ensuring accurate payments and compliance while overseeing a multidisciplinary team and collaborating with internal and external stakeholders...

Reimagine underwriting processes and enhance business profitability within the Staffing/Healthcare Vertical through expert risk assessment and team collaboration, ensuring compliance and high-quality...

Shape the future of healthcare by driving risk adjustment solutions that enhance interoperability, improve documentation accuracy, and ensure compliance across Medicare, Medicaid, and ACA programs thr...

Lead a team of SIU Investigators to combat fraud, waste, and abuse in healthcare. Collaborate with regulatory agencies while enhancing compliance strategies and overseeing health plan policy updates...

Transform compliance strategies by assessing regulations, conducting risk analyses, and guiding organizational ethics practices. Collaborate with diverse teams to ensure adherence to legal and contrac...

Unlock the potential of responsible AI governance by overseeing enterprise-wide frameworks ensuring regulatory compliance, standard adherence, and ongoing monitoring across business units while foster...

Analyze and innovate commercial insurance products, ensuring compliance with regulations. Collaborate cross-functionally to align policy language with underwriting goals while keeping pace with market...

Drive end-to-end operational excellence for stop-loss and funding processes. Oversee program administration, manage relationships with vendors, and enhance operational efficiency while leading high-pe...

Empower your career by leading a dynamic team in achieving impactful actuarial goals, enhancing pricing and forecasting strategies while ensuring compliance and personal development in a collaborative...

Optimize relationships between agents and corporate teams to drive profitable growth. Assess agent performance, ensure compliance with policies, and facilitate training, maintaining open communication...

Lead and optimize performance within the Out-of-State Medicaid function, driving operational excellence across teams to enhance client outcomes and achieve strategic revenue goals through effective le...

Shape our compliance program, ensuring regulatory compliance across HIPAA, HITRUST, and SOC 2. Drive policy creation, audit readiness, and vendor risk management while supporting M&A integration effor...

Advance your career by fostering a robust Data Governance program. Lead initiatives to ensure data integrity, compliance, and culture transformation while collaborating across teams to drive strategic...

Partner with us to manage complex P&C insurance products, optimizing performance through data analysis, market insights, and collaboration with underwriting leaders. Leverage analytics and operational...

Unlock the power of data analytics by developing insights to enhance business strategies and optimize contract performance across diverse customer segments while collaborating with teams to drive oper...

Join a dynamic team to drive actuarial modernization and innovation in life insurance. Leverage technical expertise and cross-functional collaboration to enhance client solutions and streamline proces...

Advance enterprise data governance by implementing secure data deletion processes, partnering with cross-functional teams to maintain compliance and enhance data management practices across various pl...

Join a dynamic team to strategize and optimize product commercialization for channels. Drive market insights and cross-functional collaboration to elevate product launches and ensure alignment with co...

Champion business process improvements that enhance operational efficiency and customer experience across life insurance operations. Lead cross-functional initiatives to address challenges, align stak...

Unlock potential by leading cross-functional efforts to enhance life insurance operations, driving efficiency through process improvements and strategic initiatives that transform business priorities...

Develop underwriting strategies for complex Products Liability and Contractors risks, balancing growth and profitability. Collaborate with brokers and mentor junior staff while ensuring adherence to r...

Lead investigations into insurance fraud across diverse sectors, utilizing analytical skills to detect red flags and collaborate with stakeholders. Drive comprehensive evaluations and action plans to...

Empower your career by leading a dynamic team to enhance health insurance advocacy, streamline complex claims resolutions, and optimize service delivery for better member outcomes while driving strate...

Contribute to the future of insurance sales by owning and shaping market strategies. Leveraging your deep industry connections, drive revenue growth in a complex environment, navigating buying process...

Partner with us to oversee and enhance compensation programs, ensuring effective execution and continuous improvement of processes within Workday, while collaborating closely with HR and business lead...