Health Insurance Senior Examiner Position
4 weeks ago
StrategyGen Co is seeking a highly skilled Health Insurance Senior Examiner to join our team. As a Senior Examiner, you will be responsible for evaluating health insurance issuers' compliance with state and federal laws and regulations.
Key Responsibilities:
- Evaluate health insurance issuers' compliance with state and federal laws and regulations.
- Conduct onsite or desk audits, compliance and form filing reviews, market conduct examinations, and regulatory investigations.
- Collaborate with the Examiner-in-Charge, Project Task Lead, and other project team members to develop, prioritize, and execute assigned market conduct activities.
- Identify necessary information and methodology, including required documents and data sample sizes, and prepare work plans for market conduct examinations.
- Collect and objectively analyze issuer records, files, and data to evaluate compliance with state and federal laws, regulations, and requirements.
- Document findings, prepare, and submit workpapers and other deliverables for supervisory review.
- Lead a group of examiners in conducting plan document reviews, market conduct examinations, investigations, and/or audits.
- Perform reporting and signing of market conduct examinations and audits, and ensure accurate entry into TeamMate Plus and other applicable databases.
Requirements:
- Bachelor's degree from an accredited college/university, plus 5 years of professional experience.
- Significant experience in the health insurance sector, specifically related to health care compliance, health care regulations, health care auditing, or fraud investigation.
- At least three (3) years of progressive professional work experience as an insurance auditor, including conducting market conduct examinations and MPHAEA NQTL analysis audits, and in a leadership or management role overseeing and conducting examinations, investigations, and/or audits.
- Certified Insurance Examiner (CIE) designation from the Insurance Regulatory Examiners Society, and Market Conduct Management (MCM) designation.
- Extensive knowledge of state and federal laws and regulations pertaining to the Affordable Care Act, Mental Health Parity and Addiction Equity Act, and No Surprises Act, health insurance, and/or healthcare services.
- Strong project management, organizational, communication, and writing skills, with the ability to change priorities quickly, handle multiple tasks simultaneously, and meet deadlines.
About StrategyGen Co:
We are a unique and differentiated HUBZone small business that provides highly specialized policy and regulatory specialists, market researchers, healthcare professionals, physicians, clinicians, and SME PhDs. Our vision is to improve the health of healthcare for good. We create long-term partnerships and relationships, and provide the customer with deliverables of the highest quality.
-
Senior Plans Examiner
3 weeks ago
Tampa, Florida, United States County of Volusia, FL Full timeJob Summary:The County of Volusia, FL is seeking a highly skilled Plans Examiner to join our team in the Building & Code Administration division. As a Plans Examiner, you will be responsible for examining residential and commercial plans for code and ordinance compliance, providing accurate and timely construction plan reviews, and reviewing, accepting or...
-
Senior Claims Examiner, General Liability
4 weeks ago
Tampa, Florida, United States VetJobs Full timeJob DescriptionAt VetJobs, we are seeking a highly skilled Senior Claims Examiner, General Liability to join our team. As a key member of our claims department, you will be responsible for investigating, evaluating, and resolving assigned General Liability Bodily Injury and Property Damage claims.Key Responsibilities:Investigate and evaluate claims to...
-
Medical Claims Examiner
4 weeks ago
Tampa, Florida, United States Safepoint MGA, LLC Full timeJob SummarySafepoint MGA, LLC is seeking a highly motivated and detail-oriented Medical Claims Examiner to join our team. As a Medical Claims Examiner, you will be responsible for managing a pending caseload of low to moderate severity and complexity homeowners claims in a team environment.Key ResponsibilitiesExamine claim forms and records to determine...
-
Claims Examiner Trainee
4 weeks ago
Tampa, Florida, United States Safepoint MGA, LLC Full timeJob SummaryAs a Claims Examiner Trainee at Safepoint MGA, LLC, you will be responsible for managing a pending caseload of low to moderate severity and complexity homeowners claims in a team environment. Your primary goal will be to ensure prompt, effective, and courteous handling of all claims to policyholders and claimants, while complying with appropriate...
-
Technical Claims Examiner
4 weeks ago
Tampa, Florida, United States VetJobs Full timeJob SummaryVetJobs is seeking a skilled Technical Claims Examiner to join our team. As a Technical Claims Examiner, you will be responsible for investigating, evaluating, and resolving assigned General Liability Bodily Injury and Property Damage claims.Key ResponsibilitiesInvestigate and evaluate claims to determine liability and damagesDevelop and implement...
-
Senior Claims Specialist, General Liability
4 weeks ago
Tampa, Florida, United States Travelers Insurance Full timeJob Title: Senior Claims Specialist, General LiabilityWe are seeking a highly skilled Senior Claims Specialist to join our team at Travelers Insurance. As a Senior Claims Specialist, you will be responsible for investigating, evaluating, and resolving General Liability Bodily Injury and Property Damage claims.Key Responsibilities:Investigate and evaluate...
-
Tampa, Florida, United States TerraBella Senior Living Full timeTerraBella Senior Living is a leading provider of senior living and care options with over 20 communities across the Carolinas and Georgia, boasting more than 1,500 units. Our comprehensive portfolio encompasses Active Independent Living, Assisted Living, Memory Care, and short-term Respite Care.We are seeking a highly skilled Sales Counselor to join our...
-
Senior Communications Strategist
4 weeks ago
Tampa, Florida, United States Discovery Senior Living Full timeJob SummaryDiscovery Senior Living is seeking a highly skilled Senior Communications Strategist to lead all aspects of external and internal communications and investor communications. This role will support the organization's long-term growth strategy through development and implementation of an enterprise corporate communications plan and strategy, while...
-
Primary Care Physician for Senior Population
4 weeks ago
Tampa, Florida, United States Healthwaze Full timeJob Summary:Healthwaze is seeking an experienced General Practice Physician to provide primary care for the senior population in Tampa. The ideal candidate should have experience working with managed care, HEDIS, and MRA.The General Practice Physician will provide outpatient care only and may be responsible for diagnosing conditions, prescribing medications,...
-
Senior Communications Strategist
4 weeks ago
Tampa, Florida, United States Discovery Senior Living Full timeJob Title: Senior Communications StrategistDiscovery Senior Living is seeking a highly skilled Senior Communications Strategist to lead all aspects of external and internal communications and investor communications. This role will develop and implement an enterprise corporate communications plan and strategy, while maintaining brand standards.Key...
-
Caregiver for Seniors in Tampa
1 month ago
Tampa, Florida, United States Discovery Senior Living Full timeDiscover Your PurposeWe are seeking compassionate and experienced caregivers to join our team at Discovery Senior Living. Our team is dedicated to providing exceptional care and support to our residents, and we are looking for individuals who share our passion for making a positive difference in the lives of others.Job SummaryWe are seeking a Caregiver to...
-
Caregiver & Home Health Aide
1 month ago
Tampa, Florida, United States Senior Helpers Full timeSenior Helpers: A Premier Home Health AgencyWe are seeking experienced and caring caregivers to join our team at Senior Helpers in Tampa Bay. As a leading home health agency, we offer a range of benefits and opportunities for growth and development.Key Responsibilities:Provide personal care and support to clients in their homesAssist with light housekeeping...
-
Life Insurance Sales Professional
1 month ago
Tampa, Florida, United States Jackson Insurance Solutions Full timeJob OpportunityWe are seeking a motivated and ambitious individual to join our team as a Life Insurance Sales Agent. As a remote-based position, you will have the flexibility to work from anywhere and enjoy a true work-life balance.Our company, Jackson Insurance Solutions, offers a fully commission-based position with no cap on earnings, allowing you to earn...
-
Senior Director of Marketing
4 weeks ago
Tampa, Florida, United States Discovery Senior Living Full timeJob Title: Senior Director of MarketingDiscovery Senior Living is seeking a Senior Director of Marketing to lead our national and regional brand marketing efforts in the Eastern US. This role will oversee the development and execution of quarterly/annual marketing plans for communities, interpreting and synthesizing competitive knowledge and market research...
-
Insurance Underwriter
4 weeks ago
Tampa, Florida, United States CRC Insurance Services, Inc. Full time**Job Summary**We are seeking a highly skilled Insurance Underwriter to join our team at CRC Insurance Services, Inc. The successful candidate will be responsible for identifying, soliciting, and arranging appropriate insurance coverage for clients by accessing binding authority and brokerage markets.**Key Responsibilities**Manage the underwriting process...
-
Claims Examiner
4 weeks ago
Tampa, Florida, United States Quality Carriers Full timeJob SummaryWe are seeking a highly skilled Claims Examiner to join our team at Quality Carriers. As a Claims Examiner, you will be responsible for investigating and resolving claims in a timely and cost-effective manner.Key ResponsibilitiesConduct thorough investigations of claims to determine liability and damagesNegotiate settlements with insureds and...
-
Senior Living Talent Acquisition Specialist
4 weeks ago
Tampa, Florida, United States Experience Senior Living Full timeBuild a Career with PurposeAt Experience Senior Living, we're on a mission to disrupt the experience of aging. We're seeking a talented Regional Recruiter to join our team and help us achieve this vision.Key ResponsibilitiesDevelop and implement innovative recruiting strategies to attract top talent to our senior living communitiesBuild and nurture community...
-
Home Health Caregiver
4 weeks ago
Tampa, Florida, United States Senior Helpers Full timeJob Summary: We are seeking a compassionate and caring individual to join our team as a Certified Home Health Aide (CHHA) for clients throughout central New Jersey. As a CHHA, you will provide personalized care and support to our clients, helping them maintain their independence and quality of life.Responsibilities:Provide compassionate and respectful care...
-
Personal Lines Insurance Account Manager
1 month ago
Tampa, Florida, United States Professional Insurance Services Full timeJob Title: Personal Lines Insurance Account ManagerJob Description:At Professional Insurance Services, we are seeking a motivated and detail-oriented Personal Lines Insurance Account Manager to join our dynamic team.Responsibilities:* Update client information to ensure accurate records.* Issue insurance documentation, including Certificates of Insurance...
-
Skilled Caregiver
7 days ago
Tampa, Florida, United States Senior Helpers Full timeAre you a caring and reliable professional looking for a rewarding career in home health care?Senior Helpers, a premier Home Health Agency in Tampa Bay, is currently seeking experienced caregivers to join our team.We offer a range of benefits, including:Competitive compensationReferral bonusAnnual bonusPTOEarned increasesBi-weekly payEmployee Assistance...