Conducts audits of highly complex accounts substantiating accuracy of policy classifications.
Conducts interviews to obtain information regarding the insured's operations and business model.
Determines employee job classifications based on job role, responsibilities and exposure to hazard.
CNA strives to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. They are committed to advancing a culture of inclusion – one that attracts talent from all walks of life, fosters respect and collaboration, and enables all of their colleagues to do their best work.
Responsible for performance, development, and coaching of staff.
Work with claims team and external attorneys to review coverages and resolve claims.
Partner with underwriting managers to provide excellent customer service.
Liberty Mutual is committed to delivering exceptional service and making a meaningful difference for customers. They strive to be the most trusted global brand and the best place to work, focusing on profitability and scale.
Conducts risk assessments and internal/external partner reviews.
Develops and implements risk mitigation strategies.
Advises leadership on risk-related decisions.
Pathward is a financial empowerment company that collaborates with innovators to broaden financial availability, choice, and opportunity. They are dedicated to removing traditional barriers to financial access and fostering economic mobility, with a team of problem solvers who celebrate differences and value diverse perspectives.
Design and own the QA program, including frameworks for sampling and audit cadence.
Build structured feedback loops to identify systemic quality issues and remediation opportunities.
Translate QA signals into data-backed narratives to influence prioritization across teams.
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest. Affirm is a remote-first company that offers competitive benefits and focuses on providing a simple and transparent pay structure.
Manage a portfolio of claim clients and enhance client relationships by resolving process issues.
Conduct annual reviews of administrators to ensure compliance with company requirements.
Prepare monthly reporting packages, including inventory reporting and referral analysis.
Crum & Forster’s Accident & Health division (A&H) offers specialty insurance and reinsurance products nationwide. They focus on product development and creative distribution methods, along with excellent client service and support.
Oversee enrollment and billing operations across all Government Programs including Medicare Advantage, Medicare Supplement, CHIP, and ACA products to ensure accuracy and operational performance.
Lead Medicare Advantage appeals and grievances operations to ensure timely, compliant resolution and audit readiness in accordance with CMS requirements.
Drive process improvement initiatives and cross-functional coordination to enhance regulatory outcomes, member experience, and operational efficiency.
Capital Blue Cross is a health insurance company and independent licensee of the Blue Cross Blue Shield Association that promises to go the extra mile for its team and community. It is consistently voted one of the 'Best Places to Work in PA,' fosters a flexible environment prioritizing health and wellbeing, and invests heavily in employee training and continuing education.
Partner daily with BPO leadership to own performance rhythms; manage outcomes by ensuring BPO teams embody and amplify Wealthsimple’s brand, values, and standards.
Own daily operational monitoring—tracking service level adherence, quality, CSAT, and handle time; diagnose root causes.
Lead and prepare operational reviews with partners; approach problems from first-principles to identify and lead initiatives.
Wealthsimple's mission is to help everyone achieve financial freedom – by making financial services simple, transparent, and low-cost. We're Canada's largest fintech, trusted by over 3 million clients with more than $100 billion in assets. They move fast, own their work, and care deeply about the people using their products.
Own the development and maintenance of clinical and reimbursement policies, ensuring perfect alignment with CMS regulations.
Design and oversee a robust audit program that monitors adjudication system output against clinical policies, pricing, benefit rules, and provider contract terms.
Lead the implementation of AI initiatives to automate the monitoring of reimbursement policies and contract validation.
Clover Health aims to improve the health of its members by leveraging technology and data-driven insights to provide personalized, high-quality care. They are a mission-driven team of individuals, who are passionate about solving healthcare's most complicated problems, and strive to put members first.
Supports issue resolution and maintains awareness of evolving program requirements.
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Founded in 2012 and based in Alexandria, Virginia, they employ 300+ nationwide and support more than a dozen agencies.
Lead and manage a team of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
Oversee credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational outcomes.
CertifyOS is building the data infrastructure that powers modern healthcare. They value authenticity, accountability, collaboration, results, and openness to feedback, fostering a high-ownership team focused on solving real infrastructure problems.
Develop a deep understanding of customer workflows.
Champion Qualio's agentic compliance solutions.
Become an in-house expert on Qualio's product.
Qualio is an agentic quality and compliance management platform that helps regulated organizations get products to market faster with reduced risk. The Qualio team is an all-remote, globally distributed workforce with teammates in over ten countries.
Supervise daily activities of QA specialists across multiple operational areas.
Review completed audits for accuracy and consistency.
Conduct calibration sessions to ensure scoring alignment.
Machinify is a leading healthcare intelligence company delivering unmatched value, transparency, and efficiency to health plan clients. They are deployed by over 85 health plans and are reimagining what’s possible in the industry to maximize financial outcomes and drive down healthcare costs.
Investigates claims using internal and external resources, analyzing reports and researching past claim activity to make damage and loss assessments.
Determines policy coverage through analysis of investigation data and policy terms, establishes claim reserves, and negotiates settlements within authority limits.
Maintains accurate claim file documentation throughout the life cycle of cases and alerts leadership to potential fraud or subrogation issues.
Liberty Mutual is a diversified global insurer and the third-largest property and casualty insurer in the United States. The company fosters an inclusive culture where everyone feels valued and can thrive, supported by comprehensive benefits and a commitment to professional development within a large corporate environment.
Ensures a profitable book of business by appropriately evaluating risks within established authority.
Makes subjective quality exceptions to retain profitable business with moderate supervision.
Communicates with assigned agents to educate on market appetite and explain underwriting guidelines.
Liberty Mutual strives to create a supportive and inclusive workplace where everyone feels valued. They offer comprehensive benefits, workplace flexibility, and professional development opportunities, fostering a community where individuals can make a meaningful impact.
Manage a book of business, increase account retention, and resolve complex customer service problems.
Actively seek to grow IOA business by identifying and acting on sales opportunities.
Serve as a resource to the account team and Producers.
Insurance Office of America (IOA) provides property and casualty, employee benefits, and personal lines insurance and risk management solutions as well as insurtech innovation. IOA has more than 1,300 associates located in over 60 offices in the U. S. and United Kingdom.
Manage IT audit and assurance engagements, including SOC 1, SOC 2, SOC 3, SOC for Cybersecurity, HITRUST, HIPAA, and other compliance assessments.
Collaborate with senior team members and Partners on risk assessments, audit planning, and reporting.
Lead day-to-day engagement activities, providing guidance, oversight, and feedback to staff and seniors.
Insight Assurance is a global audit firm transforming how organizations achieve cybersecurity and compliance. Founded by former Big 4 (EY) professionals, they are one of the fastest-growing global audit firms with 170+ professionals supporting nearly 2,000 clients across the Americas, EMEA, and APAC.
Responsible for processing insurance claims accurately and efficiently.
Analyze claim data to identify trends, errors, and potential irregularities.
Serve as a liaison between departments to support seamless claims resolution and continuous process improvement.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a fast-growing company serving over 200,000 seniors in 1,500+ communities across 32 states.
Office based administration work to ensure high quality and efficient processing of administration requests.
Accurate timely and efficient data entry of insurance risks as per the client standards to achieve Service Excellence.
Participate and provide support to process improvement projects.
Genpact is an agentic and advanced technology solutions company that leverages process intelligence and artificial intelligence to deliver measurable outcomes. Powered by a team with an active learning mindset and client centricity, they deliver lasting value for the world’s leading enterprises.
Responsible for the strategic oversight and successful delivery of services for the Arlo post-election audit product.
Act as the primary liaison for Product and Engineering alignment for customer success, managing onboarding, adoption, and risk.
Develop systems, metrics, and playbooks to track customer health, optimize journeys, and manage projects across multiple states.
VotingWorks is a non-partisan non-profit building open-source technology to power trustworthy elections. It operates as a small, flat, and tight-knit team striving to be both confident and humble, with a distributed workforce across nine states.
Lead a team of business analysts who own data management, operational and value reporting, and ad-hoc data requests for Risk Control.
Set strategy, partner with data science and engineering to deliver productionized models and translate those capabilities into outcomes.
Balance long-term strategic thinking with hands-on execution, defining use-cases, prototyping, and driving change management.
Liberty Mutual strives to create a workplace where everyone feels valued and supported. They build an environment that welcomes diverse perspectives, embedding inclusion in their culture and everyday interactions.