- CVS Health (Monroeville, PA)
- …in the Monroeville area, has an opportunity available for a full time Pharmacy Claims Biller/ Adjustment Specialist . As a Biller/ Adjustment Specialist ... , you will ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports prospective risk adjustment via concurrent review and supplemental data ... CMS filing, HHS-Risk Adjustment Data Validation (RADV) audit and any other chart...to the required work experience. **Licenses/Certifications:** + CCS-Certified Coding Specialist or CPS, CCS-P, CRC Upon Hire Required or… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding and ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Registered Nurse (RN) or clinical qualifications a… more
- Centene Corporation (Phoenix, AZ)
- …home. Candidate must live in Arizona. **Position Purpose:** Utilize risk adjustment methodologies, principles, and knowledge of managed care organizations to ... systems and programs. The position is responsible for using ICD10 coding and claims knowledge to support improvement of coding and medical record documentation of… 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
- AON (MA)
- Commercial Property Claims Specialist This position is responsible for managing Property Claims Management Program for a client of Aon. The position is ... conditions of the applicable incentive plan. #LI-MB1 #LI-REMOTE 2545848 Commercial Property Claims Specialist This position is responsible for managing Property … 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
- 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
- Zurich NA (Addison, TX)
- 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
- Magellan Health Services (Maryland Heights, MO)
- …to be required, acting within established parameters, this role makes the appropriate payment adjustment into the claims system. Must complete duties with a high ... talk time). Comfortable adapting to change. General Job Information Title Claims Resolution Specialist Grade 20 Work Experience - Required Claims , Customer… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …Differs from State Risk Adjuster 5 by responsibility for managing a section of claims adjustment units rather than a single unit within a section, and ... about this posting, please contact: Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: ###@la.gov...) by the absence of full authority for the claims adjustment division, and by unlimited … more
- Priority Health Care (Marrero, LA)
- JOB SUMMARY: The Revenue Cycle Specialist II must adhere to the Code of Ethical Conduct and foster positive relationships within the company, across departments, and ... include following up on claim status, billing and re-billing of claims , credit balance resolution, denial management, following up on aging accounts,… more
- Fairview Health Services (St. Paul, MN)
- …encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements. + Ensures ... Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist -Outpatient (CCDS-O), Certified Risk Adjustment Coder (CRC)… more
- Veterans Benefits Administration (Indianapolis, IN)
- Summary As a Program Specialist you will serves as the quality review and training coordinator for the division. Responsible for analyzing data associated with ... announcement, 11/21/2024. Specialized Experience for GS-11: To qualify for the Program Specialist , GS-0301-11 position, you must have at least one year (52 weeks)… 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
- MAPFRE Insurance (Webster, MA)
- Claim Specialist , Casualty (Hybrid) Date: Nov 15, 2024 Location: Webster, MA, US Company: MAPFRE Bring your passion and enthusiasm for Claims to our TEAM! At ... moderate and high severity Bodily Injury and Un/Under Insured Motorist claims . This position requires proficiency in interpreting Personal and Commercial Auto… 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
- Travelers Insurance Company (Melville, NY)
- …resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... job does not manage staff. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Travelers Insurance Company (Hartford, CT)
- …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
- Martin's Point Health Care (Portland, ME)
- …healthcare environment, including Coordination of Benefits (COB) + 1+ years of claims adjustment /research experience + Prior experience in a legal environment ... to Work" since 2015. Position Summary The Third-Party Liability Specialist is a crucial member of our team, focusing...submits of detailed annual reports to the Uniformed Services Claims Office (USCO), adhering to the contractual timelines and… more
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