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RISK ADJUSTMENT AUDITOR III - REMOTE FLORIDA

Periodic travel up to 10% for quarterly onsite meetings.The Key Responsibilities:* Performs medical record validation audits and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarc...

CompanyBlue Cross And Blue Shield Association
AddressLorida, FL
CategoryAccounting/Finance
Job typePermanent
Date Posted 2 days ago See detail

Risk Adjustment Auditor III - REMOTE FLORIDA

Blue Cross And Blue Shield Association

Lorida, FL

Periodic travel up to 10% for quarterly onsite meetings.The Key Responsibilities:* Performs medical record validation audits and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarc...

2 days ago seen See more...

Director of Credit Risk, Draper UT preferred or Remote

Optum

Draper, UT

$122,100 - $234,700 a year

Lead and manage a team of risk professional to determine and set Counterparty Credit Risk appetite and governance of Credit Risk exposures. Demonstrate strong capital markets and technical expertise to ensure that Credit Risk is a...

2 days ago seen See more...

Supervisor Risk Adjustment and Coding *Remote*

Providence

Beaverton, OR

Directly supervise the coding staff who review, interpret, code, and abstract medical record information according to coding policies and practices. Serve as the first-level supervisory position. Be responsible for assigning, dire...

4 weeks ago seen See more...

Risk Adjustment Specialist - Remote in Southern CA

Optum

Santa Ana, CA

$70,200 - $137,800 a year

Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership. Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and ad...

a month ago seen See more...

Senior Manager Risk Adjustment - Provider Initiatives (Remote - Florida Only)

Florida Blue

Jacksonville, FL

$88,100 - $110,100 a year

Oversee the staff who is primarily focused on, but is not limited to, establishing, and nurturing collaborative relationships Provider Initiatives for Risk Adjustment programs including provider quality coding chart reviews, char...

2 months ago seen See more...

Risk Adjustment Specialist - Remote in Southern CA

Optum

Los Angeles, CA

$70,200 to $137,800 per year

Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership. Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and ad...

2 months ago seen See more...

Virtual Auto Adjuster - El Paso, TX (Remote)

Allstate

Chicago, IL

$52,500 - $83,250 a year

Competitive pay with needed support for continuous development and career advancement. Flexibility in scheduling and a time off policy that helps support your work/life balance. Initial and ongoing training to get you proficient i...

3 days ago seen See more...

Claims Representative, Property Desk Adjuster (US Remote)

Swyfft

Kansas City, MO

$56.8K - $71.9K a year

This position is a 100% remote U.S. based opportunity that can be based in one of the following states only: AL, AZ, CT, DE, FL, GA, KY, LA, MA, MO, NC, NJ, NY, OH, OR, PA, SC, TN, TX, UT, VA, WA, WI.. Investigate, analyze, and de...

3 days ago seen See more...

Remote Claims Adjuster (Automotive Ancillary, Tire & Wheel, GAP, Mechanical Breakdown)

Cna National Warranty Corporation

Remote

From $40,000 a year

Over 40 years of industry leadership. Approval of over 1,200 service contract and warranty claims daily. Over $4 billion paid for customer repairs. A+ accreditation from the BBB since 2010. Consistent recognition as a #1 provider...

3 days ago seen

Risk Adjustment Coder

Apex Health Solutions

Houston, TX

$47.6K - $60.3K a year

High School Diploma or GED Required. Certified Risk Adjustment Coder (CRC). Certified Professional Coder (CPC). Certified Coding Specialist (CCS). Minimum of three (3) years HCC experience performing retrospective Risk Adjustment...

2 weeks ago seen See more...

Remote BI Adjuster I, II, or SR

National General Insurance

Alpharetta, GA

$57K - $72.2K a year

Handles investigation regarding all aspects of advanced auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority Applies advanced understanding of insurance po...

4 days ago seen See more...

Remote Complex Care Manager - High Risk Maternity

Healthfirst

New York, NY

$55.6K - $70.4K a year

Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. Conducts assessments to identify barriers and opportunities for intervention, including addressing the social determinant...

a week ago seen See more...

Virtual Auto Damage Adjuster - Collective - Remote

Allstate

Chicago, IL

$54,000 - $73,200 a year

You will live into Allstates Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each claim. You lead with empathy, always You will confident...

a week ago seen See more...

Member Risk Adjustment Coordinator I

Bcforward

Indianapolis, IN

Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement. High school diploma or equivalent. 0-2+ years of customer service or medical offic...

3 weeks ago seen See more...

Associate Claims Representative, Property Desk Adjuster (US Remote)

Swyfft

Houston, TX

You come to us with 2+ years of insurance experience in a role involving interpretation of policy provisions. Experience with desk adjusting property claims is a plus. You are currently licensed or eligible for licensing as an adj...

2 weeks ago seen See more...

Risk and Compliance Coordinator - California, Full-Time Remote

Ufw Foundation

Bakersfield, CA

Analyzes insurance needs by identifying risk exposures and analyzing and classifying risks to provide optimum coverage, costs and claim settlements. Assists UFW Foundation staff in obtaining certificates of insurance, as needed fo...

2 weeks ago seen See more...

Inside Senior Property Adjuster (Remote)

Usaa.

Dallas, TX

Manage assigned claims caseload comprised of claims with complex damages including specialty claims. Updates initial reserve levels. Partners with vendors and internal business partners to facilitate complex claims. May also invol...

2 weeks ago seen See more...

Inside Senior Property Adjuster (Remote)

Usaa.

Washington, DC

Manage assigned claims caseload comprised of claims with complex damages including specialty claims. Updates initial reserve levels. Partners with vendors and internal business partners to facilitate complex claims. May also invol...

2 weeks ago seen See more...

Inside Senior Property Adjuster (Remote)

Usaa.

Atlanta, GA

Manage assigned claims caseload comprised of claims with complex damages including specialty claims. Updates initial reserve levels. Partners with vendors and internal business partners to facilitate complex claims. May also invol...

2 weeks ago seen See more...

Physician Educator - Medicare Risk Adjustment Opening - NV

Hybridge Staffing

Nevada, United States

Physician Educator, Medicare Risk Adjustment (Openings in AZ, NV, and OR)*Employed structure*Can live in market or commute once per month*Expanding organization*Salary of $250K+ plus $62K incentive*Sign-on and relo *Full benefits*...

3 weeks ago seen See more...

Physician Educator - Medicare Risk Adjustment Opening - AZ

Hybridge Staffing

Arizona, United States

Physician Educator, Medicare Risk Adjustment (Openings in AZ, NV, and OR)*Employed structure*Can live in market or commute once per month*Expanding organization*Salary of $250K+ plus $62K incentive*Sign-on and relo *Full benefits*...

3 weeks ago seen See more...

Risk Adjustment Manager

Mid-Atlantic Permanente Medical Group

Rockville, MD

dental insurance, life insurance, parental leave, paid time off, sick time, tuition reimbursement, 401(k), retirement plan

Oversee the outcomes and operations of Risk Adjustment across the organization within all the assigned products and identifies areas of improvements and implements processes as needed. Interpret statistical analyses and helps stak...

3 weeks ago seen See more...

Administrative Assistant-Risk Adjustment

Presbyterian Healthcare Services

Albuquerque, NM

Why Join Us:. Full Time - Exempt: No. Job is based Rev Hugh Cooper Admin Center. Work hours: Days. Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more...

3 weeks ago seen See more...

Retrospective Program Manager, Medicaid Risk Adjustment

Cvs Health

Connecticut, United States

3+ years of project management experience. . 2+ years in Medicaid or Risk Adjustment health care industry experience. . Certified Risk Adjusted Coder (CRC) or Certified Professional Coder (CPC).....

3 weeks ago seen See more...

Commercial Casualty Claims Adjuster (The Mutual Group) - Remote Opportunity

Guideone Insurance

Naperville, IL

5 or more years in the handling of Commercial Liability Claims. Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims towards resolution using best pra...

3 weeks ago seen See more...

Claims Representative, Property Desk Adjuster (US Remote)

Swyfft

Houston, TX

Understanding valued policy states and knowledge of which perils apply and when tendering limits is appropriate. You are currently licensed or eligible for licensing as an adjuster in the states of: TX, FL, CA, NY, and AL (we can...

3 weeks ago seen See more...

Consultant, Cyber Risk Advisory | Remote US

Coalfire

United States

Support and guide information risk and security discussions with technical and non-technical groups. Identify enterprise information security, privacy and compliance related problems and challenges; research and develop technical...

3 weeks ago seen See more...

Associate, Cyber Risk Advisory | Remote US

Coalfire

United States

. Bachelor's degree (four-year college or university) or equivalent combination of education and work experience. Zero to two years of experience in IT and/or cybersecurity. An interest and a desire to advance your career in cyber...

3 weeks ago seen See more...

Risk Adjustment Coding Analyst

Centene Corporation

Las Vegas, NV

Validate provider, vendor, and internal diagnosis coding for accuracy by reviewing and analyzing samples of coding and claims extract compared to actual medical records. Review and identify trends in coding discrepancies and notif...

4 weeks ago seen See more...

Risk Adjustment Coder - VBC - Part-Time

U.s. Renal Care

Remote - Oregon, United States

Collaborate with Lead Coder to review CDMV progress notes and CDMV Summary. Continuous streamlined communication with NPs on queries as needed. Weekly meeting with Lead coder to discuss any barriers on receiving responses to queri...

4 weeks ago seen See more...

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