Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy ... Senior Consultant, Health Insurance - Risk Regulatory & Compliance Our Deloitte Regulatory, Risk ...
Risk Manager - Insurance
$110K - $145K/yr
Risk Manager - Insurance Fully Remote: applicants in Eastern or Central Time Zone Supporting ... Risk Assessment: Conduct comprehensive risk evaluations across property, casualty, liability ...
New
Risk Manager - Insurance
$110K - $145K/yr
Risk Manager - Insurance Fully Remote: applicants in Eastern or Central Time Zone Supporting ... Risk Assessment: Conduct comprehensive risk evaluations across property, casualty, liability ...
New
Risk Manager
Arlington, VA · On-site
$133.24K - $193.20K/yr
GENERAL RESPONSIBILITIES Consults with the Insurance Broker of Record to gather industry data and performs analyses to assess risk exposure and determine levels of risk to transfer to commercial ...
Risk Manager
Arlington, VA · On-site
$133.24K - $193.20K/yr
GENERAL RESPONSIBILITIES Consults with the Insurance Broker of Record to gather industry data and performs analyses to assess risk exposure and determine levels of risk to transfer to commercial ...
Lead Analyst, Risk Reporting
Richmond, VA · On-site +1
... Assessment narratives. * Keep abreast of evolving expectations and reporting required for areas of ... Insurance Reporting Background: 5+ years of experience in insurance risk, finance, or actuarial ...
Lead Analyst, Risk Reporting
Richmond, VA · On-site +1
... Assessment narratives. * Keep abreast of evolving expectations and reporting required for areas of ... Insurance Reporting Background: 5+ years of experience in insurance risk, finance, or actuarial ...
... Risk Assessments. * Assist and/or perform special projects and other related duties as assigned ... Strong understanding of insurance documentation and terminology. * Understand company guidelines ...
... Risk Assessments. * Assist and/or perform special projects and other related duties as assigned ... Strong understanding of insurance documentation and terminology. * Understand company guidelines ...
By integrating risk assessment, prevention, and recovery with the broader insurance experience, we help customers protect what matters most while building trust, long-term value, and sustainable ...
By integrating risk assessment, prevention, and recovery with the broader insurance experience, we help customers protect what matters most while building trust, long-term value, and sustainable ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
As an independent risk leader, you'll provide effective challenge to business risk management ... Plan Assessment and Annual Flood Insurance Review * Complete reviews of 1L SFPS policies and ...
By integrating risk assessment, prevention, and recovery with the broader insurance experience, we help customers protect what matters most while building trust, long-term value, and sustainable ...
By integrating risk assessment, prevention, and recovery with the broader insurance experience, we help customers protect what matters most while building trust, long-term value, and sustainable ...
Lead counterpartyfocused risk analysis for SF/MF portfolios, with primary responsibility for mortgage insurers, reinsurers, and/or seller/servicers. * Lead assessment of counterparty financial ...
Lead counterpartyfocused risk analysis for SF/MF portfolios, with primary responsibility for mortgage insurers, reinsurers, and/or seller/servicers. * Lead assessment of counterparty financial ...
Lead counterparty-focused risk analysis for SF/MF portfolios, with primary responsibility for mortgage insurers, reinsurers, and/or seller/servicers. * Lead assessment of counterparty financial ...
Lead counterparty-focused risk analysis for SF/MF portfolios, with primary responsibility for mortgage insurers, reinsurers, and/or seller/servicers. * Lead assessment of counterparty financial ...
Vendor Risk Assessment (VRA): * Conduct thorough risk assessments for potential and existing ... Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual ...
Vendor Risk Assessment (VRA): * Conduct thorough risk assessments for potential and existing ... Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual ...
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Rustburg, VA · On-site
$93.20K - $120.60K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Rustburg, VA. This unique ...
Quick apply
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Rustburg, VA · On-site
$93.20K - $120.60K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Rustburg, VA. This unique ...
Vendor Risk Assessment (VRA): * Conduct thorough risk assessments for potential and existing ... Life Insurance 401k/403B with Employer Match Tuition Assistance - 5,250/year and discounted ...
Vendor Risk Assessment (VRA): * Conduct thorough risk assessments for potential and existing ... Life Insurance 401k/403B with Employer Match Tuition Assistance - 5,250/year and discounted ...
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Staunton, VA · On-site
$107.20K - $138.60K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Staunton, VA. This unique ...
Quick apply
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Staunton, VA · On-site
$107.20K - $138.60K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Staunton, VA. This unique ...
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Harrisonburg, VA · On-site
$101.60K - $131.40K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Harrisonburg, VA. This unique ...
Quick apply
Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments
Harrisonburg, VA · On-site
$101.60K - $131.40K/yr
Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Harrisonburg, VA. This unique ...
Insurance Risk Assessor information
What are the key skills and qualifications needed to thrive as an Insurance Risk Assessor, and why are they important?
To thrive as an Insurance Risk Assessor, you need strong analytical skills, attention to detail, and a background in finance, mathematics, or a related field, often supported by a relevant degree or professional qualification. Familiarity with risk assessment software, data analysis tools, and industry regulations is typically required. Excellent communication, critical thinking, and negotiation skills help build trust with clients and collaborate effectively with underwriters and other stakeholders. These competencies ensure accurate risk evaluations, sound underwriting decisions, and the financial stability of insurance providers.
What are some common challenges faced by Insurance Risk Assessors when evaluating complex or unconventional insurance applications?
Insurance Risk Assessors often encounter challenges when dealing with complex or unconventional insurance applications, such as those involving unique business models, high-value assets, or emerging risks like cyber threats. These cases require a deep understanding of industry trends, regulatory requirements, and the ability to analyze incomplete or ambiguous information. Collaborating closely with underwriters, actuaries, and sometimes external experts is essential to ensure accurate risk evaluation and fair premium pricing. Staying current with continuing education and industry developments helps assessors manage these complexities effectively.
What does an Insurance Risk Assessor do?
An Insurance Risk Assessor evaluates the potential risks associated with insuring individuals or organizations. They analyze data, review applications, and assess factors like health, occupation, lifestyle, or business operations to determine the likelihood of a claim being made. Based on their findings, they recommend policy terms, coverage amounts, and premiums. Their work helps insurance companies manage risk and remain financially stable.
What is the difference between Insurance Risk Assessor vs Insurance Underwriter?
| Aspect | Insurance Risk Assessor | Insurance Underwriter |
|---|---|---|
| Credentials | Certifications like CPCU, ARM, or RIMS | Similar certifications often required |
| Work Environment | Analyzing risk data, field inspections, office work | Evaluating applications, decision-making, office-based |
| Industry Usage | Used in insurance companies, risk management firms | Core role in insurance companies, underwriting departments |
Insurance Risk Assessors analyze potential risks to determine insurance eligibility and premiums, often conducting inspections and data analysis. Insurance Underwriters evaluate applications and decide on coverage terms. While both roles require similar credentials and work environments, Risk Assessors focus on risk analysis, whereas Underwriters make final coverage decisions.
What are popular job titles related to Insurance Risk Assessor jobs in Virginia? For Insurance Risk Assessor jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Insurance Risk Assessor jobs in Virginia look for? The top searched job categories for Insurance Risk Assessor jobs in Virginia are:
Other
Posted 26 days ago
Deloitte rating
8.1
Based on 86 frontline employees who took The Breakroom Quiz
59th of 138 rated financial services
Job description
Senior Consultant, Health Insurance - Risk Regulatory & Compliance
Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk and an evolving regulatory environment into defensible actions that strengthen, protect, and transform their organizations. Join our team and use advanced data, AI, and emerging technologies with industry insights to help clients bring clarity from complexity and accelerate their path to value creation.
Work you'll do
As a Senior Consultant on our Insurance and Life Sciences team, you will:
- Review medical records, claims documentation, and benefit materials to support accurate determinations for procedures, treatments, confinements, and applicable benefits
- Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy interpretation issues, and prepare clear review rationales supported by evidence
- Apply medical coding standards and claims artifacts, including International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), UB-04, Health Care Financing Administration (HCFA) claim forms, and Explanation of Benefits documents
- Execute quality control and audit activities, identify root causes, recommend corrective actions, and support process improvements that increase accuracy, consistency, and compliance
- Develop training materials, share medical documentation and coding guidance with team members, and collaborate across United States and United States India teams to meet client expectations and service level agreements
The team
Our Regulatory & Financial Risk offering supports clients' regulatory and compliance needs, balancing risk and regulatory requirements with enhancing business value and optimizing outcomes. We deliver enhanced value through strategic transformation, end-to-end implementation, and a focus on business-as-usual sustainability across processes, controls, and data & analytic infrastructures.
Required Qualifications
- Bachelor's degree in Health Information Management, Healthcare Administration or a related field
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
- 8+ years of experience in the United States health care or health insurance industry, including claims review, claims appeals, medical billing and coding, utilization management, or payment integrity
- Experience applying International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) in claims, medical record, or appeals reviews
- Ability to work business hours aligned to the Eastern Time Zone
- Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
Preferred Qualifications:
- Experience supporting supplemental insurance claims or appeals reviews
- Experience reviewing operative reports, medical charts, Explanation of Benefits documents, UB-04 forms, or Health Care Financing Administration (HCFA) claim forms
- Experience preparing audit workpapers and traceable evidence for quality control, compliance, or regulatory review
- Experience developing or delivering training on medical documentation, coding updates, or appeals procedures
- Experience working across distributed delivery teams in the United States and India
Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $118,700 to $$218600.
Senior Consultant, Health Insurance - Risk Regulatory & Compliance
Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk and an evolving regulatory environment into defensible actions that strengthen, protect, and transform their organizations. Join our team and use advanced data, AI, and emerging technologies with industry insights to help clients bring clarity from complexity and accelerate their path to value creation.
Work you'll do
As a Senior Consultant on our Insurance and Life Sciences team, you will:
- Review medical records, claims documentation, and benefit materials to support accurate determinations for procedures, treatments, confinements, and applicable benefits
- Conduct appeals reviews for denied or underpaid claims, assess documentation, coding, and policy interpretation issues, and prepare clear review rationales supported by evidence
- Apply medical coding standards and claims artifacts, including International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), UB-04, Health Care Financing Administration (HCFA) claim forms, and Explanation of Benefits documents
- Execute quality control and audit activities, identify root causes, recommend corrective actions, and support process improvements that increase accuracy, consistency, and compliance
- Develop training materials, share medical documentation and coding guidance with team members, and collaborate across United States and United States India teams to meet client expectations and service level agreements
The team
Our Regulatory & Financial Risk offering supports clients' regulatory and compliance needs, balancing risk and regulatory requirements with enhancing business value and optimizing outcomes. We deliver enhanced value through strategic transformation, end-to-end implementation, and a focus on business-as-usual sustainability across processes, controls, and data & analytic infrastructures.
Required Qualifications
- Bachelor's degree in Health Information Management, Healthcare Administration or a related field
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
- 8+ years of experience in the United States health care or health insurance industry, including claims review, claims appeals, medical billing and coding, utilization management, or payment integrity
- Experience applying International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) in claims, medical record, or appeals reviews
- Ability to work business hours aligned to the Eastern Time Zone
- Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
Preferred Qualifications:
- Experience supporting supplemental insurance claims or appeals reviews
- Experience reviewing operative reports, medical charts, Explanation of Benefits documents, UB-04 forms, or Health Care Financing Administration (HCFA) claim forms
- Experience preparing audit workpapers and traceable evidence for quality control, compliance, or regulatory review
- Experience developing or delivering training on medical documentation, coding updates, or appeals procedures
- Experience working across distributed delivery teams in the United States and India
Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $118,700 to $$218600.