Compliance Auditor jobs at Collectivehealth, Inc. - 69 jobs

Requisition ID JR1005357 Category Operations - Premium Audit Type Regular Full-Time The Premium Audit Specialist is responsible for conducting both physical and virtual audits on high-complexity accounts, ensuring the accuracy of exposure development. This role focuses on AmTrust's larger accounts and involves managing the most complex and high-profile audits. The specialist verifies premium base exposures in accordance with policy terms, regulatory guidelines, and company procedures, while upholding AmTrust's mission, vision, and values. Candidates residing within 50 miles of an AmTrust office location may be required to abide by a hybrid in-office schedule. The expected salary range for this role is $84,300 - 100,000.00. Please note that the salary information shown above is a general guideline only. 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. Responsibilities * Independently perform audits on complex Workers' Compensation and General Liability policies, analyzing financial and operational records and conducting interviews. * Manage audits within an assigned territory, primarily large accounts; overnight travel may be required. * Act as the primary contact for assigned accounts, collaborating with insureds, underwriters, and producers. * Address and resolve complex audit disputes, ensuring compliance and coordinating with internal teams. * Confirm classification accuracy according to the governing rules; assist with test audits and bureau inquiries. * Report findings to producers, underwriters, insureds, and leadership. * Deliver exceptional service throughout the audit process. * Stay informed on industry trends and regulatory changes. * Support departmental goals as assigned. This is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time. Qualifications * 7+ years of premium audit experience with large accounts ($1M+ in premium). * Bachelor's degree in accounting, Finance, Business, or equivalent experience. * Strong written, verbal, and interpersonal communication skills. * Advanced Microsoft Excel skills (Pivot Tables, XLOOKUP); proficiency in Office Suite. * Excellent analytical, organizational, and multitasking abilities. Preferred: APA certification or progress toward certification. What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Connect With Us! Not ready to apply? Connect with us for general consideration.

Western Growers Health─a part of Western Growers Family of Companies─provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65.668.60 with a rich benefits package that includes profit-sharing. This is a remote position and can reside anywhere in the U.S. JOB DESCRIPTION SUMMARY This position reports to the Supervisor of Claims and performs in-depth audits to ensure existing health (medical/dental) benefit plans of Western Growers Assurance Trust and Pinnacle Claims Management, Inc. clients are in compliance with the respective employers' summary plan descriptions. Qualifications * BS/BA degree preferred and a minimum of one (1) to three (3) years of recent experience as a medical/dental claims auditor. * Three (3) years' experience processing group health claims preferred. * Knowledge of Current Procedural Terminology (CPT) and International Statistical classification of Diseases and Related Health Problems (ICD-10 & ICD-9) and medical terminology. * Exceptional understanding and interpretation of summary plan descriptions of employee medical/dental benefits. * Good ability to interpret provider contracts. * Proven ability as a self-starter to manage timelines and commitments. * Proficient in end-user software, e.g., word-processing and spreadsheets. * Exceptional written and verbal communication skills. * Good knowledge of basic business math. Duties And Responsibilities Claims Auditing * Perform routine and moderately complex audits on paper and electronic claims for payment integrity in alignment with regulatory and timelines standards, business policy, and contract terms. * Ensure appropriate coding and system configuration of claims with the ability to extract and audit exception audit reports. * Research claim processing problems and errors to determine their origin and appropriate resolution. * Prepare reports and summarize observations and recommendations for management. * Participate in communication with management regarding trends in order to improve claims processing accuracy and documented business rules for incorporation into training programs, policies, and procedures. * Perform special project audits and reviews as requested by other departments/regions. Claims Department Support * Identify and escalate issues related to instructional material that is inaccurate, unclear or contains gaps and provide recommendations for correction of this material. * Confer with management to assess training needs in response to changes in policies, procedures, regulations, and technologies. * Participate in departmental error logs analytics and includes the findings in training preparations. * Provide technical support, training assistance, and expertise to claims staff or other department as determined through audit findings. * Support and assist management team in updating department policies and guidelines. Pinnacle Risk Management Services - Claims - PM6000 * Adjudicate specific stop loss claims received from Third Party Administrators in accordance with stop loss policy terms and the plan document. Process complex claims for physician, hospital, and specialty areas with high degree of accuracy and productivity. * Process stop loss claim adjustments, refunds, and checks according to company policies and procedures, within established dollar authority. * Respond and assist with claim documentation and reports as needed. * Identify process improvement opportunities and works to implement corrective actions. * Coordinate and communicate claims status with reinsurance carrier. * Work with AVP of Claims, Claims Manager and Reinsurance Analyst as required Other * Utilize all capabilities to satisfy one mission - to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results. * All other duties as assigned. Physical Demands/Work Environment The physical demands and work environment described here represent those that an employee must meet to perform this job's essential functions successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate. #LI-Remote

Description Western Growers Health─a part of Western Growers Family of Companies─provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65.668.60 with a rich benefits package that includes profit-sharing. This is a remote position and can reside anywhere in the U.S. JOB DESCRIPTION SUMMARYThis position reports to the Supervisor of Claims and performs in-depth audits to ensure existing health (medical/dental) benefit plans of Western Growers Assurance Trust and Pinnacle Claims Management, Inc. clients are in compliance with the respective employers' summary plan descriptions.Qualifications BS/BA degree preferred and a minimum of one (1) to three (3) years of recent experience as a medical/dental claims auditor. Three (3) years' experience processing group health claims preferred. Knowledge of Current Procedural Terminology (CPT) and International Statistical classification of Diseases and Related Health Problems (ICD-10 & ICD-9) and medical terminology. Exceptional understanding and interpretation of summary plan descriptions of employee medical/dental benefits. Good ability to interpret provider contracts. Proven ability as a self-starter to manage timelines and commitments. Proficient in end-user software, e.g., word-processing and spreadsheets. Exceptional written and verbal communication skills. Good knowledge of basic business math. Duties And ResponsibilitiesClaims Auditing Perform routine and moderately complex audits on paper and electronic claims for payment integrity in alignment with regulatory and timelines standards, business policy, and contract terms. Ensure appropriate coding and system configuration of claims with the ability to extract and audit exception audit reports. Research claim processing problems and errors to determine their origin and appropriate resolution. Prepare reports and summarize observations and recommendations for management. Participate in communication with management regarding trends in order to improve claims processing accuracy and documented business rules for incorporation into training programs, policies, and procedures. Perform special project audits and reviews as requested by other departments/regions. Claims Department Support Identify and escalate issues related to instructional material that is inaccurate, unclear or contains gaps and provide recommendations for correction of this material. Confer with management to assess training needs in response to changes in policies, procedures, regulations, and technologies. Participate in departmental error logs analytics and includes the findings in training preparations. Provide technical support, training assistance, and expertise to claims staff or other department as determined through audit findings. Support and assist management team in updating department policies and guidelines. Pinnacle Risk Management Services - Claims - PM6000 Adjudicate specific stop loss claims received from Third Party Administrators in accordance with stop loss policy terms and the plan document. Process complex claims for physician, hospital, and specialty areas with high degree of accuracy and productivity. Process stop loss claim adjustments, refunds, and checks according to company policies and procedures, within established dollar authority. Respond and assist with claim documentation and reports as needed. Identify process improvement opportunities and works to implement corrective actions. Coordinate and communicate claims status with reinsurance carrier. Work with AVP of Claims, Claims Manager and Reinsurance Analyst as required Other Utilize all capabilities to satisfy one mission - to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results. All other duties as assigned. Physical Demands/Work EnvironmentThe physical demands and work environment described here represent those that an employee must meet to perform this job's essential functions successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate. #LI-Remote

Senior Premium Audit Specialist - Dallas, Texas | Open to All Locations (Work From Home) KEY OBJECTIVE The Premium Audit Specialist is responsible for the timely and accurate servicing on assigned Chubb Global Casualty PEO programs. The Premium Audit Specialist works in a consulting role in support of ongoing efforts to improve business processes and profitability (mainly expense side impact) MAJOR DUTIES AND RESPONSIBILITIES Provide Chubb Global Casualty (CGC) Dallas branch and program support on our Professional Employer Organization (PEO) accounts to ensure that policies, premium audits and associated data are technically accurate and are performed in compliance with manual rules, Chubb Corporate Policies and Procedures, regulatory requirements and sound Premium Audit Practices and Principles. Ensure that premium audits on PEO policies are completed in a timely & accurate manner through audit oversight, ongoing evaluation of client data, MGA partner's processing, and potential outside audit vendor work. Assist Premium Audit Manager to establish, document and implement cost-effective and efficient business processes and procedures with solid controls in place. Ensure that Bureau Test Audits standards are met or exceeded. Determine action required of Chubb; work with Regulatory Compliance, Claims, Unit Statistical Reporting, and any other department to ensure overall bureau requirements are met. Assist with compiling, validating, claims review, and reconciliation of program audit data for assigned PEO accounts. Assist with further development and documentation of criteria and selection process for PEO client company reviews, and interim test audits to ensure classifications accuracy and compliance with state and manual rules. Assist with identification and regular selection of client companies for formal review and/or interim test audits for all PEOs as directed, documenting selections in accordance with current procedures. Conduct interim test audits, and formal reviews of PEO client companies as directed, coordinating with PEO contact when necessary for client contact to ensure correct classification use. Complete test audit reports and/or review forms, consistently based on regular selections, providing test audit reports to PEO, while maintaining up to date digital audit files and summary documentation in the designated locations on the network drive for each PEO, in accordance with current procedures. Coordinate policy audits for processing into Chubb's WC System via MGA partners, and reconciling data to ensure its accuracy. Provide ongoing support and monitoring of assigned PEO's audit department issues or procedures to ensure that appropriate handling of classification and exposure issues. Assist underwriters in assigning classifications for prospective PEO client companies as needed in order to ensure proper classification of employees at inception. Develop and maintain good working relationships and demonstrate ability to work as a team with internal partners (Regulatory Compliance Department, Unit Statistical Department, Financial Operations, business unit leaders, etc.) and external partners (PEO clients, MGA partners, TPA Partners, etc.) to effectively develop and implement process workflow changes/enhancements. Experience & Education: Successful completion of a college level curriculum or equivalent experience, professional designations a plus. Working knowledge of P&C insurance businesses and audit processes. Knowledge of insurance accounting processes and systems, receivable and financial discipline. Demonstrated WC premium audit competence as evidenced by a minimum of three years of WC Premium Audit experience. Out of three years, a minimum of one year should be with primary focus on California risks requiring the interpretation and application of WCIRB manual rules. Thorough knowledge of Workers' Compensation classification system, basic manual rules, and industry advisory resources. Thorough knowledge of Microsoft Excel (relevant release versions), including effective tools and methods for importing, analyzing, combining, and manipulating large worksheets with extensive data. Excellent interpersonal skills, with the ability to quickly build relationships with others, to effectively communicate goals and procedures as well as educate clients, staff and other individuals of all professional levels in a positive manner. Demonstrated commitment to perform job duties in accord with the highest ethical standards. Excellent conflict avoidance and resolution skills, with the ability to deescalate situations involving agitated clients, using verbal communication. Demonstrated creative analytical and problem-solving skills, with flexibility and openness to outside ideas. Ability to provide exceptional customer service in a proactive way that minimizes problems and enhances relationships with internal and external clients. Demonstrated initiative and self-motivation to effectively manage time and workload, including multiple unrelated assignments simultaneously, while maintaining service standards with minimal supervision. Strong attention to detail and follow-through skills. Must be able to work independently. Must be able to travel periodically as needed, not anticipated to exceed 10%

Objective, Typical Duties and Responsibilities We're currently seeking a Compliance Specialist to support the firm's Compliance Program. You will report to Manager-Compliance Operations Develop and manage a Compliance Department activity reporting system. Represent the compliance department in resolving issues involving new accounts set up with Operations and Accounting departments. Monitor general department email inboxes and/or department ticketing system reports to assure timely response or escalation if necessary to inquiries and information received. Provide support, education, and guidance to Financial Representatives and their staff as it relates to business processes, firm policies and procedures, industry rules, and other general inquiries. Assist management and other compliance personnel with the completion of various projects and testing. Other duties as assigned. Position Requirements Bachelor's degree (B.A./B.S.) in a related discipline required. Minimum two (2) years of Compliance and/or regulatory experience within both RIA and broker-dealer business segments., Series 7, 24 (or 26), 63, 65 (or 66), Series 53 (or 51), and Life, Health, & Variable Annuity Insurance Licenses (or the ability to obtain within 120 days of hire). Strong working knowledge of both brokerage and investment advisory business concerning the regulatory framework in which they operate. A deep understanding of industry rules governing supervision, suitability, and registrations. Excellent technology and communication skills Ability to work independently to manage time and prioritize tasks efficiently. Be a motivated self-starter who can make thoughtful, deliberate decisions with minimal assistance. The desire to be an enthusiastic, cooperative team player who is always seeking ways to improve processes. Preference Given to Candidates with the Following Qualifications: Have previous experience with and a thorough understanding of regulatory requirements under Reg-BI and PTE 2020-02. Already hold a Life, Health, & Variable Annuity license. Compensation The salary for this position generally ranges between $75,000-90,000. This range is an estimate, based on candidate qualifications and operational needs. The firm also has a bonus program. Perks & Benefits 401(k) with Employer Match Health Insurance (with HSA option) Dental Insurance Perks & Benefits (continued) Vision Insurance Life Insurance Flexible Paid Time Off Policy Flexible Spending Account (FSA) Healthy Work/Life Balance Maternity/Paternity Leave Policy Remote Work Opportunity About World Investment Advisors As part of World Insurance Associates, LLC World Investment Advisors is a nationally recognized financial services firm dedicated to providing the industry's premier wealth management and retirement plan investment advisory services to individuals, high net worth families and employers. Stimulating Environment At World Investment Advisors, we strive to provide a challenging, stimulating environment for the best and brightest in the industry. We believe our employees can best serve our clients and advisors in an atmosphere where individuals are treated fairly, where professional growth is fostered and encouraged, and where a healthy balance between work and home life is respected and preserved. We promote a friendly and collaborative work environment. We are motivated by team camaraderie and are obsessed with doing the right thing for our plan sponsor clients and their plan participants. Team-Oriented Professionals typically work together in teams with multiple people from different departments to meet our clients' needs. Our junior staff works with their team members to develop the skills and knowledge to succeed and assume more senior level positions as they progress at our firm. We welcome team members from different backgrounds with different perspectives to help us innovate and make a difference for our customers and our communities. Why World? Great company culture with an awesome team-oriented atmosphere! Mentorship Opportunities Ability to serve on different internal steering committees (Charitable Giving, DEI, Social, etc.) Professional growth opportunities Friendly and collaborative work environment Employee perks including fun team building opportunities, yoga/wellness, charitable giving/volunteering World Investment Advisors is an equal opportunity employer. We believe the most effective way to attract, develop and retain a diverse workforce is to build an enduring culture of inclusion and belonging. World is committed to equality and deeply believes in diversity in sexual orientation, gender, race, religion, ethnicity and other qualities that makes us all different. To Executive Search Firms and Staffing Agencies: World does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered World's property, and World will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting World's Human Resources Talent Department. #LI-GP1 #LI-REMOTE

To accurately perform concurrent, retrospective, and special audits on all level I claim types for all Partnership lines of business. Responsibilities Perform concurrent and retro claims audits on new Claims examining staff and on claims processed by existing Claims staff as outlined in Claims Operating Instruction Memorandums for all lines of business. Document audits and report all audit outcomes following the Partnership Claims Operating Instruction Memorandums on claims auditing. Maintain current knowledge of Partnership Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations. Perform special claims audits as assigned. SECONDARY DUTIES AND RESPONSIBILITIES Participate in special projects and assignments as required. Other duties as assigned. Qualifications Education and Experience Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience. Special Skills, Licenses and Certifications Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems. Understanding of claims examining requirements. Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Excellent oral and written communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Ability to work on multiple tasks within established time frames and sometimes conflicting priorities. Good organizational skills with ability to maintain accurate records and documentation of actions and decisions. Work Environment And Physical Demands Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $ 30.38 - $ 36.46 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Sia Partners is a next-generation management consulting firm. We offer a unique blend of AI and design capabilities, augmenting traditional consulting to deliver superior value to our clients. Counting 3,000 consultants in 19 countries, we expect to achieve $420 million in revenue for the current fiscal year. With a global footprint and expertise in more than 30 sectors and services, we optimize client projects worldwide. Through our Consulting for Good approach, we strive for next-level impact by developing innovative CSR solutions for our clients, making sustainability a lever for profitable transformation. Job Description One of our premier clients is seeking a seasoned professional with expertise in infrastructure data center compliance to join our growing Tech practice. The ideal contractor will have 5 years of management consulting experience in the financial services or tech industry, with a deep understanding of data center infrastructure, data center compliance (security, resilience, incident response, environmental, workplace safety), and associated risks. Your role will involve collaborating with client teams, designing and enhancing compliance frameworks, and ensuring adherence to regulatory standards. Conduct in-depth assessments of client compliance controls and processes for alignment with regulatory frameworks Identify gaps in compliance efforts and propose actionable solutions Review audit documentation (SOC 2, ISO 27001, SOX) to integrate existing controls into a new compliance framework Design and develop compliance frameworks tailored to global data center operations, addressing themes like physical security, incident management, and vendor risk Develop and refine policies, procedures, and controls in collaboration with client teams Ensure frameworks are scalable and adaptable to meet evolving regulatory requirements Work closely with client's Second Line of Defense (2LOD) teams to ensure alignment and effective implementation. Lead the pilot implementation of compliance programs with designated client teams. Develop monitoring mechanisms and reporting structures to track compliance progress. Conduct regular reviews to ensure effectiveness and sustainability of implemented controls. Standardize processes and templates for broader implementation across client operations. Provide ongoing support and guidance for continuous improvement of compliance programs. Communicate the impact of regulatory changes to client teams and adjust frameworks accordingly. Create detailed project plans, compliance documentation, and reports for client leadership and stakeholders. Provide clear deliverables, including frameworks, policies, procedures, and audit-readiness materials. Support internal initiatives, thought leadership, and people development Support client work and lead the development of high-quality, timely client deliverables Prepare for and facilitate successful client and internal meetings Collaborate with internal and external teams to share knowledge and best practices Technical knowledge Physical Infrastructure & Environmental Controls Technical Facilities Assurance (Fac Ops) standards and protocols Environmental Health and Safety (EHS) requirements and compliance Data Center Infrastructure Management (DCIM) systems Heating, Ventilation, and Air Conditioning (HVAC) security controls Power Distribution Unit (PDU) security configurations Uninterruptible Power Supply (UPS) redundancy systems Building Management Systems (BMS) security Computer Room Air Conditioning (CRAC) monitoring systems Environmental Monitoring Systems (EMS) implementation Asset Management & Lifecycle IT Business Operations Systems (IBOS) for asset tracking Electronic Records and Asset Disposal (ERAD) procedures Configuration Management Database (CMDB) implementation IT Asset Management (ITAM) best practices Hardware Security Module (HSM) management Asset Lifecycle Management (ALM) processes Qualifications Bachelor's degree in business or a related field 5+ years of experience in data center compliance / risk management Strong knowledge of data centers, infrastructure, processes, and risks Proven communication, interpersonal, and organizational skills Ability to adapt quickly and take initiative in unstructured environments with limited supervision Willingness to share knowledge and expertise with colleagues and clients Ability to transform domain knowledge and project experiences into published content for Sia Partners Insights Experience with data center regulations and standards preferred. Certification in risk management or a related field (e.g. CISA, CRCMP, CISM, CRISC) a plus. Strong knowledge of relevant risk management frameworks, such as SOC 2, ISO 27001, SOX Additional Information Compensation Information : The Anticipated compensation range for this opportunity is between $120,000-139,000 annually plus bonus. At this time, Sia Partners does not intend to pursue employment with applicants who will require now or in the future visa sponsorship by our company for work authorization in the United States (i.e., H1-B visa, F-1 visa (OPT), TN visa, or any other non-immigrant status). Our Commitment to Diversity Diversity, equity, inclusion, and belonging (DEIB) are part of Sia Partners' DNA. Thanks to our expertise in several sectors and our international growth, our teams include a variety of experiences and cultures. We're confident that promoting DEIB creates an environment in which everyone can reach their full potential. Our global network, DEIB@Sia Partners, brings together our people worldwide to facilitate local and global progress, focused on the following areas: Gender equality (global Gender Equality Index score of 91/100 for FY19-20) LGBTQ+ Race & Ethnicity Working Parents Disabilities Sia Partners is an equal opportunity employer. All aspects of employment, including hiring, promotion, remuneration, or discipline, are based solely on performance, competence, conduct, or business needs. To learn more about our mission, values, and business sectors, please visit our website . Sia Partners is an equal opportunity employer. All aspects of employment, including hiring, promotion, remuneration, or discipline, are based solely on performance, competence, conduct, or business needs. Sia Partners is an equal opportunity employer. All aspects of employment, including hiring, promotion, remuneration, or discipline, are based solely on performance, competence, conduct, or business needs.

Your Role The Internal Audit Services team performs internal audits and advisory services to provide assurance on specific internal control objectives and emerging risk areas. The Internal Audit Principal will report to the Internal Audit Senior Director. In this role, you will be leading and managing financial, operational, and integrated audits and advisory engagements. You will also be assessing the design and effectiveness of internal controls for business processes, financial reporting and measurement activities, and related applications in accordance with laws, regulations, policies, standards, and procedures using established tools and techniques. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires a minimum of 10 years of prior related experience Ability to communicate with executive leadership regarding matters of significant importance to the organization Extensive understanding of internal controls and the ability to leverage this knowledge to make effective audit and advisory recommendations Internal audit and risk assessment practices and methodologies. IT general and automated technical controls concepts, application controls and end-user computing controls. AI and data analysis techniques preferred Healthcare and pharmacy audit experience preferred Certified Internal Auditor (CIA) and/or Certified Information Systems Auditor (CISA) preferred Your Work In this role, you will: Execute the annual audit plan by independently performing audit procedures, including identifying and defining issues, developing criteria, reviewing, and analyzing evidence, and documenting management processes and procedures. Audits entail end to end process reviews, can be cross functional and complex. Provide expertise in internal controls including project management, business process analysis, financial control disciplines, and information technology Implement strategic goals established by Internal Audit Services leadership Support Internal Audit management is the annual risk assessment process to develop the annual audit plan Identify, develop, and document audit issues and recommendations using independent judgment concerning areas being reviewed Prepares and delivers reports and presentations to various levels of management Performs post-audit follow-up reviews to ensure management corrective action plans have been effectively implemented Provides measurable input into new products, processes, standards, and/or operational plans that impact Internal Audit Services, and proactively improves upon existing processes and systems using significant conceptualizing, reasoning, and interpretation Conducts extensive investigation and critical thinking to understand root causes of problems that span a wide range of difficult and unique issues across functions and/or businesses Manages large, complex project initiatives of strategic importance to the organization, involving large cross-functional teams. May direct the work of other individual contributors and/or act as a cross-functional team lead

Your Role The Quality Review team completes audits of front-line staff to ensure alignment with department processes and regulatory compliance. Clinical Quality Auditors also provide coaching and work closely with business leaders to drive optimal results. The Clinical Quality Auditor, Consultant will report to the Quality Review Senior Manager. In this role you will develop performance metrics, evaluate performance, and provide coaching to ensure that staff have the skills and knowledge required to be successful in Population Health Management and Utilization Management. Your Knowledge and Experience Requires a Bachelor's of Science in Nursing or advanced degree preferred Current California RN license required At least 7 years of experience in managed care or similar complex healthcare environment with a minimum of 1 year experience in Case Management required Auditing experience preferred Population Health Management and Utilization Management experience preferred Strong organizational and/or project management skills to coordinate departmental projects and to perform multiple projects or tasks simultaneously Subject matter expert with capability to effectively audit and train all lines of business (Commercial, Federal Employee Program, Medicare, and Medi-Cal) Your Work In this role, you will: Perform audits for Population Health Management (PHM) and Care Coordination adhering to monthly productivity and quality metrics. Review audit data to identify care gaps, compliance risks, and trends. Communicate findings to leadership and provide recommendations to mitigate risks. Design, implement, evaluate and improve audit criteria and coaching strategies to meet the needs of PHM clinical staff. Provide developmental coaching and support to all staff to improve the skills and competencies required to successfully perform work. Conduct effective presentations relating to PHM processes and/or regulatory compliance for clinical staff. May independently represent the Quality Review department in PHM and work re-design, process changes and software implementation. Act as a resource for the training and auditing team

Job Opportunity: Senior Premium Auditor We are currently seeking a Senior Premium Auditor with a strong and extensive background in completing Workers' Compensation and General Liability audits for construction risks. This role involves collaboration with a managing general agent (MGA), audit processing centers, various departments within Chubb, and third-party vendors. The position is primarily remote, with audits completed through a remote physical audit process. However, onsite physical audits may be required as necessary. While preference is given to candidates residing in California, we welcome applications from individuals regardless of their location. Responsibilities: Manage all aspects of field scheduling and inventory management. Resolve audit questions, disputes, and assist with rating bureau criticisms. Build and maintain productive, professional relationships with producers and customers to ensure high-quality audit services. Performance will be evaluated based on productivity, time service, technical quality, and interpersonal communication. Provide feedback and conduct quality reviews for third-party vendors as needed. Ensure compliance with established Chubb audit guidelines. Collaborate with internal premium audit staff, managing general agents (MGA), and other Chubb business units. Required Skills: Proficiency in analyzing electronic payroll information. Comprehensive knowledge of Workers' Compensation statutory rules and requirements across all 50 states. Familiarity with accounting records and bookkeeping methods. Intermediate to advanced expertise in Microsoft Excel, including pivot tables, formulas (relative and absolute), VLOOKUP, ranges, and more. Strong verbal and written communication skills, with the ability to explain audit requirements to insureds or risk managers effectively. Excellent time management skills to meet deadlines while managing multiple assignments simultaneously. Self-discipline to work independently with minimal supervision while keeping relevant parties informed. Initiative and self-motivation to manage inventories effectively. Ability to work both independently and collaboratively as part of a team. Consistently interact with others in a positive, respectful, and professional manner. Commitment to upholding the highest ethical standards in all job responsibilities. Experience and Education: At least five (5) years of experience delivering premium audit services to construction accounts. Knowledge of casualty insurance; professional insurance designations such as APA or CPCU are a plus. A four-year college degree or equivalent business experience in the Premium Audit field. Proficiency in Microsoft Office Suite and other business-related software applications. Chubb Individual Contributor Competences Problem Solving: Takes an organized and logical approach to addressing problems and complex issues. Simplifies complexity by breaking down issues into manageable parts. Looks beyond the obvious to identify root causes and develop insights. Continuous Learning: Demonstrates a commitment to expanding expertise, developing new skills, and growing professionally. Actively seeks opportunities to learn and deepen technical knowledge. Embraces challenging assignments that foster professional growth. Initiative: Exceeds expectations by taking ownership of tasks and meeting objectives with minimal supervision. Demonstrates self-motivation and a willingness to go the extra mile. Seizes opportunities to make a positive impact. Adaptability: Adjusts personal efforts in response to changing circumstances. Receptive to new ideas and approaches. Effectively prioritizes competing demands and navigates uncertainty with confidence. Results Orientation: Executes plans effectively, drives for results, and takes accountability for outcomes. Perseveres in challenging situations and capitalizes on opportunities. Takes full responsibility for achieving desired results. Values Orientation: Upholds Chubb's values and consistently acts with integrity. Builds trust through honesty and professionalism. Fosters collaboration within teams and across the organization, embodying the “One Chubb” mindset. The pay range for the role is $ 81,100-$137,800.The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

To accurately perform concurrent, retrospective, and special audits on all level I claim types for all Partnership lines of business. Responsibilities Perform concurrent and retro claims audits on new Claims examining staff and on claims processed by existing Claims staff as outlined in Claims Operating Instruction Memorandums for all lines of business. Document audits and report all audit outcomes following the Partnership Claims Operating Instruction Memorandums on claims auditing. Maintain current knowledge of Partnership Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations. Perform special claims audits as assigned. SECONDARY DUTIES AND RESPONSIBILITIES Participate in special projects and assignments as required. Other duties as assigned. Qualifications Education and Experience Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience. Special Skills, Licenses and Certifications Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems. Understanding of claims examining requirements. Valid California driver's license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Excellent oral and written communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Ability to work on multiple tasks within established time frames and sometimes conflicting priorities. Good organizational skills with ability to maintain accurate records and documentation of actions and decisions. Work Environment And Physical Demands Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $ 30.38 - $ 36.46 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Who We Are: ManhattanLife Insurance and Annuity Company was founded in 1850, the Company's longevity makes it one of the oldest, most reliable health and life insurance companies in the country. Operating successfully for 175 years is a testimony to ManhattanLife's enduring history, and an indicator of the reliability of our future. ManhattanLife's headquarters are in Houston, TX and the company is continually growing with multiple office locations nation-wide. ManhattanLife offers attractive employee benefits starting day one, including immediate coverage under our health, dental and vision plans. We offer flexible schedules, including shortened hours on Fridays, free parking, company-wide events, professional development (LOMA testing) and a company-wide wellness program. Our success is a result of a focus on continual growth, personalized customer service, and financial soundness. At ManhattanLife, our employees are at the core of our success. Our corporate culture rewards individual contributions and teamwork. We value diversity, unique abilities, and experience. We seek individuals who want to use their talents and expertise to contribute to our continued growth and success while providing our customers with superb customer service, care, and compassion. Scope and Purpose: We are seeking recent college graduates to take on our Filing and Compliance Analyst position in our growing headquarters and operations office. The ideal candidate will be eager to expand their knowledge about filing applications with states for the company to sell and market its products. As our Filing and Compliance Analyst, you will work to ensure that insurance regulations and filing requirements are met. This position is a great opportunity to start your professional career. Duties and Responsibilities: Preparation and submission of filings for company line products and programs to all State Insurance Departments. Communication to State Insurance Departments to ensure approval of filings. Create and update insurance contracts for filing with State Departments of insurance. Internal coordination with various levels of the organization to maintain open communication and collaboration to secure information necessary to complete a filing. Interaction with Departments of Insurance on policy/contract filings. Distribute State objections to the appropriate individuals and ensure responses are received and submitted within the required time-frames. Obtain copies of statutes and regulations that have been referenced in a State objection and distribute to responsible party. Finalize responses to State objections with accurate and appropriate attachments for submission to the State. Minimum Qualifications: Bachelor's Degree in English, Communications, Business Administration, Political Science, or in a related field preferred. Knowledge, Skills and Abilities: At least 2 years of insurance, paralegal, and/or medical experience preferred. At least 1 year of Insurance Product filing experience, preferably using SERFF. Ability to write documents in a concise, professional manner. Attention to detail and high accuracy. Legal research and writing experience is preferred. Thorough, organized, and works well independently; collaborates as needed. Able to take constructive feedback. Highly proficient in Microsoft Office products. Travel Requirements This position may require light travel within a ten-mile radius from one office location to another as needed. Professional Development: Establish annual objectives for professional growth. Keep pace with developments in the discipline. Learn and apply technologies that support professional and personal growth. Participate in the evaluation process. Physical Demands The physical demands described here are representative of those that must be met by an employee to success fully perform the essential functions of this job. Reasonable accommodations may enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle or feel objects, type, and use mouse; reach with hands and arms and talk and/or hear. The employee is required to sit for extended periods of time. The position may require lifting, pulling or moving items weighing upwards of 10 pounds as it relates to office or desk supplies. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee regularly works in an office environment. This role routinely uses standard office equipment such as computers, phones via WebEx, physical phone while in office, and photocopiers when necessary. Other Duties Please note this is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to the job at any time without notice. AAP/EEO Statement ManhattanLife prohibits discrimination based on race, religion, gender, national origin, age, disability, veteran status, marital status, pregnancy, gender expression or identity, sexual orientation, or any other legally protected status. EOE Employer/Vet/Disabled. ManhattanLife values differences. We are committed to fostering an environment that attracts and retains a diverse workforce. With individuals from a variety of backgrounds, ManhattanLife will be better equipped to service our customers, increase innovation, and reduce risks. We encourage the unique perspectives of individuals and are dedicated to creating a respectful and inclusive work environment.

About us: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities Are you an experienced insurance professional with a sharp eye for detail and a passion for accuracy? Join our team as a Senior Premium Auditor and help ensure fair, compliant, and data-driven premium assessments for our policyholders. Responsibilities Conduct premium audits-virtually or in person-on Workers' Compensation, Businessowners', and other commercial policies. Review financial records (e.g., payroll, sales, tax documents) to verify exposures and classifications. Communicate professionally with policyholders, agents, and internal teams to gather and validate information. Prepare clear, accurate audit reports that support compliance and transparency. Provide guidance and support to junior auditors. Stay informed on regulatory updates and industry standards (ISO, NCCI, state-specific rules). Identify trends or discrepancies and escalate potential issues when needed. Qualifications Minimum of 3 years of premium audit experience, especially in Workers' Compensation, General Liability, or Commercial Auto. Audit experience in FL, CA, and NY/NJ/PA required A degree in Accounting, Finance, or Business is helpful-but equivalent experience is equally valued. Performed audits for diverse lines of business nationwide Familiarity with audit principles and tools preferred (e.g., Visual Audit, Nexus, proprietary systems). Strong analytical skills and attention to detail. Effective communication and time management abilities. Comfort working independently and collaboratively. Certifications like CPCU or APA are a plus but not required. Salary Range 60,000-100,000 USD. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required.

Are You Driven? We Are. We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make daily. At GAINSCO, it is our people that set us apart. If you are looking for a place where you can make a difference, understand how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you. Why Join GAINSCO? GAINSCO's work environment rewards engaged individuals who have a desire to contribute and succeed. That's because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a Champion with GAINSCO. Are you a compliance leader with deep expertise in claims governance and regulatory requirements? GAINSCO is seeking a Compliance & Governance Manager to oversee claims guidelines, SOPs, and regulatory compliance across multiple jurisdictions. This role ensures consistent, compliant claims handling practices while driving process improvements and supporting strategic initiatives. What does the COMPLIANCE AND GOVERANCE MANAGER do at GAINSCO? * Develop and maintain governance framework for Claims SOPs, guidelines, and correspondence templates. * Coordinate procedural updates with Claims leadership and ensure alignment with training materials. * Serve as the subject matter expert for claims procedures and compliance standards. * Maintain version control and documentation for all SOPs and guidelines. * Research and interpret new or changing claims regulations across operating states. * Lead compliance readiness for new state entries and manage adjuster licensing and CE compliance. * Partner with Legal and Compliance teams to implement regulatory updates. * Ensure claim correspondence templates meet jurisdictional and regulatory standards. * Maintain audit trails for SOP and process updates. * Support internal, external, and regulatory audits with documentation and compliance evidence. * Collaborate with QA to align quality standards with compliance requirements. * Communicate compliance updates and procedural changes to stakeholders. * Partner with Training to integrate compliance changes into onboarding and continuing education. * Represent Claims in enterprise-level compliance discussions. * Identify and implement process improvements to strengthen governance and compliance tracking. * Recommend technology or workflow enhancements to improve efficiency. * Support strategic projects related to compliance and governance. What is required? Education: * Bachelor's degree in Business Administration, Insurance, Risk Management, or related field required. Certifications: * Professional designation (e.g., CPCU, AIC, SCLA) preferred. Experience: * 8+ years of progressive experience in P&C claims, including multi-jurisdictional oversight is required. * 2+ years managing claims compliance or governance processes (SOP development, regulatory research, audit readiness) is required. * 2+ years of leadership experience in claims operations, compliance, or process improvement is required. * Strong understanding of state-specific regulatory requirements and licensing obligations. * Experience collaborating with Legal, Compliance, Training, and Technology teams. * Experience with claims management or compliance tracking systems. Other skills and abilities: * Strong critical thinking and problem-solving abilities. * Ability to analyze complex regulations and translate them into practical operational solutions. * Excellent organizational and project management skills. * Exceptional communication and collaboration skills with senior leaders. * High attention to detail with a focus on accuracy, documentation, and governance. What else do you need to know? * Hybrid * Excellent benefits package medical & dental, vision insurance, life insurance, short-term and long-term disability insurance. * Parental Leave Policy * 401K + Company Match * PTO Plan + Paid Company determined Holidays. Applicants are required to be eligible to lawfully work in the U.S. immediately; employer will not sponsor applicants for U.S. work authorization (e.g. H-1B visa) for this opportunity All offers are contingent upon a successful background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO. GAINSCO is an Equal Employment Opportunity Employee

Are You Driven? We Are. We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make daily. At GAINSCO, it is our people that set us apart. If you are looking for a place where you can make a difference, understand how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you. Why Join GAINSCO? GAINSCO's work environment rewards engaged individuals who have a desire to contribute and succeed. That's because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a Champion with GAINSCO. Are you a compliance leader with deep expertise in claims governance and regulatory requirements? GAINSCO is seeking a Compliance & Governance Manager to oversee claims guidelines, SOPs, and regulatory compliance across multiple jurisdictions. This role ensures consistent, compliant claims handling practices while driving process improvements and supporting strategic initiatives. What does the COMPLIANCE AND GOVERANCE MANAGER do at GAINSCO? Develop and maintain governance framework for Claims SOPs, guidelines, and correspondence templates. Coordinate procedural updates with Claims leadership and ensure alignment with training materials. Serve as the subject matter expert for claims procedures and compliance standards. Maintain version control and documentation for all SOPs and guidelines. Research and interpret new or changing claims regulations across operating states. Lead compliance readiness for new state entries and manage adjuster licensing and CE compliance. Partner with Legal and Compliance teams to implement regulatory updates. Ensure claim correspondence templates meet jurisdictional and regulatory standards. Maintain audit trails for SOP and process updates. Support internal, external, and regulatory audits with documentation and compliance evidence. Collaborate with QA to align quality standards with compliance requirements. Communicate compliance updates and procedural changes to stakeholders. Partner with Training to integrate compliance changes into onboarding and continuing education. Represent Claims in enterprise-level compliance discussions. Identify and implement process improvements to strengthen governance and compliance tracking. Recommend technology or workflow enhancements to improve efficiency. Support strategic projects related to compliance and governance. What is required? Education: Bachelor's degree in Business Administration, Insurance, Risk Management, or related field required. Certifications: Professional designation (e.g., CPCU, AIC, SCLA) preferred. Experience: 8+ years of progressive experience in P&C claims, including multi-jurisdictional oversight is required. 2+ years managing claims compliance or governance processes (SOP development, regulatory research, audit readiness) is required. 2+ years of leadership experience in claims operations, compliance, or process improvement is required. Strong understanding of state-specific regulatory requirements and licensing obligations. Experience collaborating with Legal, Compliance, Training, and Technology teams. Experience with claims management or compliance tracking systems. Other skills and abilities: Strong critical thinking and problem-solving abilities. Ability to analyze complex regulations and translate them into practical operational solutions. Excellent organizational and project management skills. Exceptional communication and collaboration skills with senior leaders. High attention to detail with a focus on accuracy, documentation, and governance. What else do you need to know? Hybrid Excellent benefits package medical & dental, vision insurance, life insurance, short-term and long-term disability insurance. Parental Leave Policy 401K + Company Match PTO Plan + Paid Company determined Holidays. **Applicants are required to be eligible to lawfully work in the U.S. immediately; employer will not sponsor applicants for U.S. work authorization (e.g. H-1B visa) for this opportunity** All offers are contingent upon a successful background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO. GAINSCO is an Equal Employment Opportunity Employee

The ESIS Claims Compliance Specialist is responsible for ensuring compliance and supporting operational excellence within the claims department. This role involves preparing annual reports for self-insured accounts, responding to the Self-Insured Audit Committee, supporting special projects, preparing files for carrier and state audits, and providing general office support. The specialist implements quality plans, monitors results, and recommends corrective actions as needed. This position reports to and receives direction from the Claims Manager. Duties & Responsibilities include, but are not limited to: Prepare annual reports for self-insured accounts, including claims data and financial information, for submission to California's DIR Office of Self-Insurance Plans (OSIP) by March 1st each year. This includes the annual report, actuarial study, and audited financials. Review and prepare files for PAR Audits to ensure timely and accurate payments, proper documentation, and correct wage calculations. Review and prepare files for Carrier Audits to ensure compliance with carrier guidelines. Collaborate with the Claims Manager to improve overall Quality Review (QR) scores, including auditing individual files for compliance with QR guidelines. Participate in special projects as assigned. Assist in the preparation of Claims Loss Reports (CLR). Complete Executive Loss Summary (ELS) reports, maintain a log of all reports due, and ensure timely compliance. Support the training of new hires and provide ongoing training for existing employees, working with the Learning & Development team and in-house trainers to develop training schedules. Review the progress and status of claims with the Team Leader, discuss issues, and recommend remedial actions. Prepare and submit reports on unusual or potentially undesirable exposures to the Team Leader. Assist in penalty reduction initiatives. Support the Team Leader in developing methods and improvements for claims handling. Assist the Claims Vice President, Claims Manager, Team Leaders, and Claims Handlers with special projects, including reserve analysis, account-specific projects, closing projects, and audits. Minimum of five years' experience managing workers' compensation claims, with demonstrated career progression in a similar role or organization. Proven ability to work independently with minimal supervision. Strong organizational skills with a demonstrated ability to meet deadlines. Advanced technical knowledge of claims handling processes and related terminology. Excellent communication and interpersonal skills, with the ability to interact effectively with claimants, customers, insureds, brokers, and attorneys. Solid understanding of company products, services, coverages, policy limits, and claims best practices. Comprehensive knowledge of applicable state and local laws relevant to workers' compensation. Commitment to delivering high-quality customer service. California Certified Self-Insurance Plan (SIP) certification preferred. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. The pay range for the role is $71,000 to $114,400. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled. ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.

The ESIS Claims Compliance Specialist is responsible for ensuring compliance and supporting operational excellence within the claims department. This role involves preparing annual reports for self-insured accounts, responding to the Self-Insured Audit Committee, supporting special projects, preparing files for carrier and state audits, and providing general office support. The specialist implements quality plans, monitors results, and recommends corrective actions as needed. This position reports to and receives direction from the Claims Manager. Duties & Responsibilities include, but are not limited to: Prepare annual reports for self-insured accounts, including claims data and financial information, for submission to California's DIR Office of Self-Insurance Plans (OSIP) by March 1st each year. This includes the annual report, actuarial study, and audited financials. Review and prepare files for PAR Audits to ensure timely and accurate payments, proper documentation, and correct wage calculations. Review and prepare files for Carrier Audits to ensure compliance with carrier guidelines. Collaborate with the Claims Manager to improve overall Quality Review (QR) scores, including auditing individual files for compliance with QR guidelines. Participate in special projects as assigned. Assist in the preparation of Claims Loss Reports (CLR). Complete Executive Loss Summary (ELS) reports, maintain a log of all reports due, and ensure timely compliance. Support the training of new hires and provide ongoing training for existing employees, working with the Learning & Development team and in-house trainers to develop training schedules. Review the progress and status of claims with the Team Leader, discuss issues, and recommend remedial actions. Prepare and submit reports on unusual or potentially undesirable exposures to the Team Leader. Assist in penalty reduction initiatives. Support the Team Leader in developing methods and improvements for claims handling. Assist the Claims Vice President, Claims Manager, Team Leaders, and Claims Handlers with special projects, including reserve analysis, account-specific projects, closing projects, and audits. Minimum of five years' experience managing workers' compensation claims, with demonstrated career progression in a similar role or organization. Proven ability to work independently with minimal supervision. Strong organizational skills with a demonstrated ability to meet deadlines. Advanced technical knowledge of claims handling processes and related terminology. Excellent communication and interpersonal skills, with the ability to interact effectively with claimants, customers, insureds, brokers, and attorneys. Solid understanding of company products, services, coverages, policy limits, and claims best practices. Comprehensive knowledge of applicable state and local laws relevant to workers' compensation. Commitment to delivering high-quality customer service. California Certified Self-Insurance Plan (SIP) certification preferred. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. The pay range for the role is $71,000 to $114,400. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled. ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.

Argo Group International Holdings, Inc. and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions. Job Description The Underwriting Quality Auditor ensures the integrity, consistency, and compliance of underwriting practices across all lines of business. This role evaluates underwriting files, identifies risk and process gaps, and provides actionable feedback to drive accuracy, authority management, adherence to company guidelines, and regulatory compliance. Responsibilities: * Audit underwriting files to assess quality, accuracy, and compliance with company policies, appetite and authority statements, underwriting guidelines, and regulatory requirements. * Document findings and provide concise and constructive feedback and recommendations to underwriters and management. * Identify training opportunities and process improvements to enhance underwriting performance and reduce error trends. * Prepare reports and presentations summarizing audit results, trends, and recommendations for senior management and monitor improvements. * Maintain awareness of regulatory, market, and internal policy changes impacting underwriting practices. * Support internal and external audit requests and contribute to continuous improvement of the Quality Assurance framework. * Participation in regular departmental planning meetings and other projects as assigned. Required Qualifications * 5+ years of underwriting experience with an Excess & Surplus or Property & Casualty Insurance Carrier * Proficiency in Microsoft Office 365 suite including Microsoft Excel Preferred Qualifications * Background in quality assurance, claims, compliance, or knowledge of multiple insurance lines including specialty lines is a plus. * Working knowledge of underwriting systems, raters, workflows, and insurance regulations. * Strong written and oral communication skills * High degree of interpersonal effectiveness with a demonstrated ability to articulate review findings and make a case for change to leaders across various profit centers. * A high degree of discipline and self-motivation to manage multiple audits and deadlines simultaneously. * Strong analytical and investigative skills. * 4-year Degree from an accredited University The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package. * Chicago - $97.1k - $114.4k * New York City - $105.9k - $124.7k * Richmond, Omaha, San Antonio - $88.3k - $104k PLEASE NOTE: Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas. If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at ************. Notice to Recruitment Agencies: Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions. We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics. The collection of your personal information is subject to our HR Privacy Notice Benefits and Compensation We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. : The Clinical Quality Auditor performs comprehensive audits within the skilled home health, hospice, and behavioral health agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations. The Auditor's areas of focus to ensure quality outcomes will include, but are not limited to, ICD-10 coding, Outcome and Assessment Information Set (OASIS), Value Based Purchasing (VBP), Care Compare, and clinical documentation. At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there's no place like home, and that's why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their health journey, we care. Each team member has a part to play in this mission. This means you have countless ways to make a difference as a Clinical Quality Auditor, by keeping a team of elite healthcare professionals operational. To continue to be an industry pioneer delivering unparalleled care, we need a Clinical Quality Auditor who shares our commitment to distinction and progress. Are you one of them? If so, apply today! Why Join the Elara Caring mission? Work in a collaborative environment. Be rewarded with a unique opportunity to make a difference Competitive compensation package Tuition reimbursement for full-time staff and continuing education opportunities for all employees at no cost Opportunities for advancement Comprehensive insurance plans for medical, dental, and vision benefits 401(K) with employer match Paid time off, paid holidays, family, and pet bereavement Pet insurance What is Required? Associate degree in Nursing is required 3 years of experience as a Registered Nurse in home health and/or hospice Current state license as a Registered Nurse Certified Homecare Coding Speicalist (HCS-D), or willing to obtain within 6 months Certified OASIS Specialist-Clinical (COS-C), or willing to obtain within 6 months Good communication skills both written and verbal Proven organizational development and project management skills Exhibits working knowledge of regulations and reimbursement in home health, hospice, and behavioral health Ability to maintain the confidentiality of sensitive financial, clinical, and operational information You will report to the Director of Quality Audit and Education. This is not a comprehensive list of all job responsibilities ; a full will be provided. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. We value the unique skills of veterans and military spouses. We encourage applications from military veterans and their families. Elara Caring provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age (40 and older), national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, protected veteran status, or any other basis prohibited under applicable federal, state or local law. Elara Caring participates in E-Verify and we will provide the Federal Government with your Form I-9 information to confirm that you are authorized to work in the United States. Employers like Elara Caring can only use E-Verify once you have accepted the job offer and completed the Form I-9. At Elara Caring, pay and compensation are determined by a variety of factors, including education, job-related knowledge, skills, training, and experience. Our compensation structure reflects the cost of labor across different U.S. geographic markets, and may vary based on location. This is not a comprehensive list of all job responsibilities and requirements; upon request, a job description can be provided. If you are an individual with a disability and are unable or limited in your ability to use or access our career site as a result of your disability, you may request reasonable accommodations by reaching out to ********************.