Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes ... Previous Provider File or equivalent experience (Required) * Proficient in MS Office - Word, Excel ...
Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes ... Previous Provider File or equivalent experience (Required) * Proficient in MS Office - Word, Excel ...
Technical Reviewer
Corona, NY · On-site
$70K - $80K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$70K - $80K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes ... Previous Provider File or equivalent experience (Required) * Proficient in MS Office - Word, Excel ...
Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes ... Previous Provider File or equivalent experience (Required) * Proficient in MS Office - Word, Excel ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
Corona, NY · On-site
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Technical Reviewer
$39K - $46K/yr
They will interpret laboratory reports, review air sampling reports, and may issue Notices of Violation, prepare case files and evidence; provide testimony at Environmental Control Board Hearings and ...
Be Seen First
Paralegal / Litigation
Clifton, NJ · On-site
$30 - $36/hr
File Review, Tracking Discovery End Dates. PIP Applications. Open Mail. Letter of Protection. Manage a caseload of over 80 active personal injury cases. Manage case files from inception through trial ...
Quick apply
Be Seen First
Paralegal / Litigation
Clifton, NJ · On-site
$30 - $36/hr
File Review, Tracking Discovery End Dates. PIP Applications. Open Mail. Letter of Protection. Manage a caseload of over 80 active personal injury cases. Manage case files from inception through trial ...
Be Seen First
Paralegal / Litigation
Clifton, NJ · On-site
$30 - $36/hr
File Review, Tracking Discovery End Dates. PIP Applications. Open Mail. Letter of Protection. Manage a caseload of over 80 active personal injury cases. Manage case files from inception through trial ...
Quick apply
Be Seen First
Paralegal / Litigation
Clifton, NJ · On-site
$30 - $36/hr
File Review, Tracking Discovery End Dates. PIP Applications. Open Mail. Letter of Protection. Manage a caseload of over 80 active personal injury cases. Manage case files from inception through trial ...
Managing Clerk
New York, NY · On-site
$100K - $153K/yr
Prepare, review, and electronically file legal documents in federal, state, and local courts, primarily in New York and New Jersey. * Support Delaware court filings and filings in other jurisdictions ...
Managing Clerk
New York, NY · On-site
$100K - $153K/yr
Prepare, review, and electronically file legal documents in federal, state, and local courts, primarily in New York and New Jersey. * Support Delaware court filings and filings in other jurisdictions ...
Obtains needed information from case files, law enforcement agencies, civil client agencies, or ... review and approval. Prepares such legal actions as indictments, complaints, search warrants ...
Obtains needed information from case files, law enforcement agencies, civil client agencies, or ... review and approval. Prepares such legal actions as indictments, complaints, search warrants ...
NO-FAULT PIP ADJUSTER
Long Island City, NY · On-site
$50K - $60K/yr
Review all No-Fault communications received on assigned files. * Review and monitor files for closing. * Review all medical and expense bills submitted for duplication, and issue payment as ...
NO-FAULT PIP ADJUSTER
Long Island City, NY · On-site
$50K - $60K/yr
Review all No-Fault communications received on assigned files. * Review and monitor files for closing. * Review all medical and expense bills submitted for duplication, and issue payment as ...
Quality Assurance Examiner - General Liability / E&O
Manhattan, NY · On-site
$117 - $172/hr
With skills in leadership, collaboration, and relationship-building, you'll share file review results and host calibration sessions. In the spirit of continuous improvement, you'll use your ...
Quality Assurance Examiner - General Liability / E&O
Manhattan, NY · On-site
$117 - $172/hr
With skills in leadership, collaboration, and relationship-building, you'll share file review results and host calibration sessions. In the spirit of continuous improvement, you'll use your ...
Affordable Housing Compliance Expert | Housing
New York, NY · On-site +1
$171K/yr
Review files for accuracy - Audit resident files across LIHTC (Section 42), HUD Section 8 (HCV, PBV, and PBRA), USDA Rural Development, and related programs for compliance with program rules * Own ...
Affordable Housing Compliance Expert | Housing
New York, NY · On-site +1
$171K/yr
Review files for accuracy - Audit resident files across LIHTC (Section 42), HUD Section 8 (HCV, PBV, and PBRA), USDA Rural Development, and related programs for compliance with program rules * Own ...
Additional services include In-service training workshops for general education and special education teachers, as well as Child Study Team file review to assist with compliance. We also provide ...
Additional services include In-service training workshops for general education and special education teachers, as well as Child Study Team file review to assist with compliance. We also provide ...
Manager, Home Office Underwriting
New York, NY · On-site +1
Key Responsibilities Underwriting Audit & Quality Review Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Manager, Home Office Underwriting
New York, NY · On-site +1
Key Responsibilities Underwriting Audit & Quality Review Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Manager, Home Office Underwriting
Morristown, NJ · On-site +1
Key Responsibilities Underwriting Audit & Quality Review Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Manager, Home Office Underwriting
Morristown, NJ · On-site +1
Key Responsibilities Underwriting Audit & Quality Review Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Manager, Home Office Underwriting
Morristown, NJ · On-site +1
Key Responsibilities Underwriting Audit & Quality Review • Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Manager, Home Office Underwriting
Morristown, NJ · On-site +1
Key Responsibilities Underwriting Audit & Quality Review • Plan and execute underwriting audit activity, including pre-audit planning, file review, fieldwork, reporting, and post-audit follow-up. ...
Compliance Manager (LIHTC)
Corona, NY · On-site
$90K/yr
File Review & Quality Assurance * Conduct detailed initial reviews of up to 150 files per week, ensuring accuracy, completeness, and program eligibility prior to submission to regulatory agencies.
Compliance Manager (LIHTC)
Corona, NY · On-site
$90K/yr
File Review & Quality Assurance * Conduct detailed initial reviews of up to 150 files per week, ensuring accuracy, completeness, and program eligibility prior to submission to regulatory agencies.
File Review & Quality Assurance * Conduct detailed initial reviews of up to 150 files per week, ensuring accuracy, completeness, and program eligibility prior to submission to regulatory agencies.
File Review & Quality Assurance * Conduct detailed initial reviews of up to 150 files per week, ensuring accuracy, completeness, and program eligibility prior to submission to regulatory agencies.
File Reviewer information
What is a file reviewer?
A File Reviewer is responsible for evaluating documents, records, or applications to ensure accuracy, compliance, and completeness. They typically work in industries like finance, insurance, legal, or healthcare, where document verification is crucial. Their duties may include identifying errors, verifying data against established criteria, and providing feedback on necessary corrections. Strong attention to detail and knowledge of relevant regulations are essential for this role.
What skills and qualifications are needed to thrive as a file reviewer?
To thrive as a File Reviewer, you need a strong attention to detail, analytical thinking, and an understanding of regulatory or compliance standards typically gained through relevant education or experience. Familiarity with document management software, databases, and sometimes industry-specific tools like mortgage or insurance platforms is often required. Excellent organizational abilities, time management, and effective written communication skills help individuals excel in this role. These competencies are critical to accurately evaluating files, ensuring compliance, and supporting business operations efficiently.
What are common challenges faced by file reviewers, and how can they be managed?
File Reviewers often face challenges such as managing large volumes of documents within tight deadlines and ensuring each file meets strict compliance standards. Staying updated on changing regulations or internal policies can also require continuous learning and adaptability. To manage these challenges, strong organizational skills and effective prioritization are essential, along with utilizing digital tools that streamline review processes. Many teams support collaboration and provide ongoing training to help File Reviewers stay efficient and maintain high accuracy. As you gain experience, you'll become skilled at identifying discrepancies quickly and contributing to quality assurance within your team.

EmblemHealth rating
9.4
Based on 7 frontline employees who took The Breakroom Quiz
15th of 315 rated insurance
Job description
Summary of Job
Conduct vendor performance auditing and support maintenance of provider data integrity across core operational processes. Ensure adherence to contractual requirements, regulatory expectations, and customer experience standards through routine audits and follow-up. Contribute to analytics and continuous improvement initiatives by compiling data, tracking results, and escalating issues as needed. Compile and share data quality and workflow findings with business partners; track follow-ups and escalate issues as needed.
Responsibilities
- Audit vendor performance for each core process to help ensure contractual requirements are met and results align with EmblemHealth customer experience objectives.
- Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes; document results and escalate trends or issues to leadership.
- Resolve day-to-day operational issues by researching root causes, coordinating with business partners and vendors, and documenting outcomes; escalate higher-risk issues and recommend enhancements to management for prioritization and execution.
- Maintain audit and assessment records; document findings, variances, and supporting evidence; and escalate results to management for analysis and development of corrective actions.
- Complete project activities and contribute knowledge within project teams and workgroups aligned with department initiatives.
- Share process knowledge and best practices with peers and new team members as requested.
- Participate in cross-functional and vendor related projects as assigned.
- Perform other duties as directed, assigned, or required.
Qualifications
- Bachelor's degree
- 2 - 3+ years of relevant professional work experience including auditing and assessment activities (Required)
- Additional years of related experience/specialized training may be considered in lieu of degree requirements (Required)
- Strong collaboration skills and the ability to communicate effectively with stakeholders (Required)
- Strong auditing skills that can be applied across all types of business problems (Required)
- Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences (Required)
- Ability to organize, prioritize, and successfully manage multiple competing tasks/projects simultaneously (Required)
- Previous Provider File or equivalent experience (Required)
- Proficient in MS Office - Word, Excel, Access, PowerPoint, Outlook, Teams, SharePoint, etc. (Required)
- Requisition ID: 1000003222
- Hiring Range: $48,600-$83,160
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Benefits
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About EmblemHealth
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
New York, NY, US
Year founded
1937