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Furthermore, this position partners with the County's ERM and Claims Analyst in maintaining County insurance policies, risk assessments, synthesizing and presenting risk data, legal contract review, and oversight of a diverse claims portfolio that includes both insured and self-insured programs.
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Familiarity with HIPAA, HITRUST, and other healthcare related standards and regulations. Other duties could include supporting security awareness training, customer inquiries, and security certification activities (HITRUST, SOC2, HIPAA.
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Experience in conducting audits and developing audit plans (e.g., SOC2, HITRUST). RVO Health was created by joining teams from both Red Ventures and UnitedHealth Group's Optum Health. Develop, implement, and maintain a comprehensive GRC program to ensure compliance with relevant laws, regulations, and industry standards (e.g., HIPAA, PCI DSS.
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Supports site HR representatives regarding Workers Compensation claims to ensure appropriate return to work and the prompt settlement of claims. Experience as Radiation Safety Officer (RSO) desirable.
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You will work in a dynamic team, collaborating with the DevOps Team Lead and Principal Architect to build and maintain secure enterprise-wide cloud environments that meet the stringent security requirements of a HIPAA/HITECH/HITRUST environment.
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Performs research on a variety of legal subjects which may include, but are not limited to: Federal and state/territory code, and legislative proposals; military justice and status issues for Title 10 and Title 32 members; claims; labor relations; equal opportunity; administrative actions; contractual agreements; ethics; environmental concerns; law enforcement; bankruptcy; taxation; legal assistance; and a wide variety of miscellaneous legal issues.
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You will assist in the investigation and remediation of security events and/or incidents, participate in the design and execution of vulnerability and risk assessments, penetration tests, and security audits (e.g., HITRUST, SOC2), and work closely with technology and business teams to document and track remediation of known security issues.
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Handle warranty claims on all hardware. System familiarity in these programs would be a plus but not required: Mitel, security system maintenance, CRM maintenance experience, access point deployment, VMware, Veeam, Linux, firewall, Adobe Suite, Audio/Video systems.
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Health care industry and Medicare Part D rules and regulations, Medicaid services, claims adjudication process, CMS guidance, and the life cycle of PDE data. Proven understanding of the health care industry and or BCBSMN area s of Medicare Part D rules and regulations, Medicaid services, claims adjudication process, CMS guidance, and the life cycle of PDE data.
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Develop processes and manage downstream contract administration including request for information (RFI’s), submittals, change management, contract closeout, documentation, and claims mitigation.
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Conducting and managing forensic accounting consulting engagements which may consist of economic damages analyses, business interruption insurance claims, fraud investigations, fraud risk assessments, or financial dispute resolution, often for litigation purposes.
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Experience leading or participating in formal security audits (i.e. HITRUST, SOC2, FedRAMP) Experience leading or participating in formal security audits (i.e. HITRUST, SOC2, FedRAMP) Experience in penetration testing, vulnerability scanning, CVSS and/or other general security testing principles.
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At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities to put customers at the center of what we do best - protecting and restoring their dreams when they need us most.
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We provide high quality and cost-effective "hands-on" restoration services with appropriate turnaround times that contractors, claims professionals, and homeowners require. As we strive to accommodate our customers and their restoration needs, Prism Specialties expanded into art restoration, document restoration, and textile restoration.
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Position Overview"Remote Option Available" The Sr. Group Claims Examiner, analyzes high dollar claims and determines eligibility of Group Reinsurance claims. Responsibilities Under supervision, analyzes and determines eligibility of Group Reinsurance Medical or Managed Care claims; interprets and verifies that the reinsurance claim was properly ceded to RGA Group Re and the proper provisions and limits are established on RGA Group Re’s administration system.
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claims hitrust jobs Company: Smart Data Solutions in St Paul, MN
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