- Hartford HealthCare (Farmington, CT)
- …cycle industry practices. The audit and education specialist will support documentation practices that comply with CMS risk adjustment program requirements ... common practices across the system. *_Position Summary:_* The Audit & Education Specialist develops and implements an effective and comprehensive audit & education… more
- Highmark Health (Hartford, CT)
- …categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing ... **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health… more
- Elevance Health (Rocky Hill, CT)
- **Referral & Resource Specialist ** **Location:** This is a **remote** position. Candidates must reside in one of the following states : **MASSACHUSETTS, NEW ... companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive… more
- MetLife (Bloomfield, CT)
- …customers and our communities. The Senior Long Term Disability (LTD) Claims Specialist evaluates long term disability insurance claims in accordance with plan ... prescribed time service standards. In this role, the Senior LTD Claims Specialist is required to exercise independent judgment, critical thinking skills, exemplary… more
- MetLife (Bloomfield, CT)
- …performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced ... brokers, and family members during claim evaluations * Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes… more
- Highmark Health (Hartford, CT)
- …requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members' health conditions and optimize risk adjusted ... Health Record (EHR) systems preferred. + Proficiency in navigating and retrieving clinical information from EMR/HER systems + Working knowledge of HIPAA requirements… more