- 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
- Wheeler Clinic (Bristol, CT)
- Family Support Specialist -Functional Family Therapy-Foster Care- Bristol Bristol, CT 06010, USA Req #1636 Wednesday, January 15, 2025 Wheeler's vision is that all ... growth at all stages of life. POSITION SUMMARY The Family Support Specialist provides direct services/case management/coordination of care to an assigned caseload of… 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
- Baylor Scott & White Health (Hartford, CT)
- …**KEY SUCCESS FACTORS** + Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and compliance with standards of ethical ... + Conducts provider audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology + Interprets health record documentation to code and… 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
- Hartford HealthCare (Torrington, CT)
- …for HHCAH to be a strategic partner generating qualified referrals and building new clinical initiatives. In general, most of the time will be spent in the following ... HHCAH service lines for system and non-system partners -Identifying patients at risk during transition to home (or SNF) using standard tools of assessment.… more