- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, HHS-Risk ... guidelines. The development and ongoing maintenance of the Commercial Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are… more
- Fallon Health (Worcester, MA)
- …provider groups. + Identify diagnoses for submission as well as deletion in support of claims adjustment efforts + Ensure chart reviews and related claims ... report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details and… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST ** **Location:** Trinity Health PACE Corp Michigan ... ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical… more
- City of New York (New York, NY)
- …Bureau of Law & Adjustment (BLA) is responsible for investigating and adjusting claims filed for and against the City of New York. The Real Property Division ... . PREFERRED SKILLS IN ADDITION TO MINIMUM REQUIREMENTS - Comprehensive knowledge of claims , including the investigation, adjustment and disposition of claims… more
- Zurich NA (Schaumburg, IL)
- General Liability Claims Specialist I 112465 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it ... our General Liability team. As a General Liability (GL) Claims Specialist , you will work with a...develop and maintain strong relationships. + Understanding of the claims adjustment process and ability to determine… more
- City of New York (New York, NY)
- …employees serving in a permanent (not provisional) Civil Service title of Claim Specialist . To be considered for this position, PLEASE CLEARLY INDICATE YOUR CURRENT ... Charter, the Comptroller, through the Bureau of Law and Adjustment (BLA), negotiates and approves all monetary settlement of... (BLA), negotiates and approves all monetary settlement of claims and lawsuits involving the City of New York.… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …CLAIMS OPERATIONS Necessary Contacts: In order to effectively fulfill this position, the Claims Specialist I must be in contact with personnel in other Units: ... Duties may include the following responsibilities or functions required to support the claims unit. Accurate processing of claims edits, determining primacy for… more
- HUB International (Ellicott City, MD)
- …Experience with personal and commercial lines claims . + Proficiency with claims reporting, advocacy, status and reserve adjustment concerns. + Proficiency ... We currently have an opportunity for a **Claim Service Specialist ** to join our team in our **Ellicott City,...automobile and homeowners and commercial lines property and casualty claims activity in accordance with the practices, policies and… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined...and monitoring on a regular basis for any needed adjustment ; + Presenting cases to management for expense or ... theirs, too. Join our team as we help shape the future. As a Claims Specialist , you will be responsible for handling a caseload of complex, high exposure, auto… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined...and monitoring on a regular basis for any needed adjustment ; + Presenting cases to management for expense or ... theirs, too. Join our team as we help shape the future. As a Claims Specialist , you will be responsible for handling a caseload of complex, high exposure, auto… more
- Providence (Mission Hills, CA)
- …with established policy guidelines. Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for ... **Description** Responsible for processing medical claims . Resolves complex, difficult or non-routine claims requiring special handling in accordance… more
- Health First (Rockledge, FL)
- …required. * Certification: o Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification. o Certified Risk Adjustment Coder (CRC) from ... *POSITION SUMMARY * Contribute to Health First Health Plans Risk Adjustment activities that support compliance with regulatory and contractual requirements specific… more
- City of New York (New York, NY)
- …that impact the public fiscal and public safety. The Bureau of Law & Adjustment is responsible for investigating and adjusting claims filed for and against ... employees serving in a permanent (not provisional) civil service title of Claim Specialist . Please clearly state your permanent civil service title on your resume… more
- Aston Carter (Morristown, NJ)
- Job Title: Data Entry/ Claims Specialist Job Description * Facilitate the First Notice of Loss process, ensuring timely and accurate intake of initial claim ... details. * Coordinate the setup and processing of new legacy claims including entry of claim payments, reserve transactions and recoveries into the claims … more
- Federal Highway Administration (Lakewood, CO)
- …aspects of highway design and construction, and experience resolving contractor claims and requests for equitable adjustments. Responsibilities As a Civil Engineer ... (Highway - Claims Engineer), you will: Provide contract administration advice to...Contract Branch Chief. Provide engineering expertise to Acquisition Contract Specialist in reviewing and evaluating contractor requests for equitable… more
- Aerotek (Tempe, AZ)
- …the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and ... **Overview:** **Aerotek has an immediate opening for a Junior Workers Compensation Specialist at the corporate office in Tempe, AZ.** **Job Summary:** Reporting to… more
- City of New York (New York, NY)
- …attention to the long-term challenges we face together. The Bureau of Law & Adjustment is responsible for investigating and adjusting claims filed for and ... employees serving in a permanent (not provisional) civil service title of Claim Specialist . Please clearly state your permanent civil service title on your resume… more
- Travelers Insurance Company (Centennial, CO)
- …resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... until December 27th, 2024. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Travelers Insurance Company (Morristown, NJ)
- …and resolving assigned Specialty Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... not manage staff. **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures quality and timely coverage… more
- Travelers Insurance Company (Tampa, FL)
- …and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... not manage staff. **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures file quality and timely coverage… more