- buyer (New York, NY)
- …committed to building strong relationships with its members and providers.Position OverviewAs a Claims Adjustment Specialist I, this individual will be ... in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... and documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Risk Adjustment Coding Specialist will be responsible for the chart review and ICD-10 diagnosis ... coding of risk adjustment eligible members. This position will have responsibility for...GED required. Associates degree preferred. + CCS/CCS-P (Certified Coding Specialist ) or CPC/CPC-A (Certified Coding Professional) required. If CCA… more
- The Hartford (San Antonio, TX)
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Specialist...and monitoring on a regular basis for any needed adjustment . + Presenting cases to management for expense or… more
- Aston Carter (Seattle, WA)
- Job Title: Sr. Claims Specialist Job Description This is a 100% remote position requiring work on Pacific Standard Time (PST). The role is pivotal in ... Visio, Microsoft Project). Additional Skills & Qualifications + Experience in claims processing, data entry, human resource administration, and financial relief. +… more
- Aston Carter (Portland, OR)
- …resolution/settlement and payment process. This role provides administrative support to the Claims Manager and Claims Specialist , and involves interaction ... Job Title: Claims AssistantJob Description The Claims Assistant...request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process… more
- Adecco US, Inc. (San Juan, PR)
- …include but are not limited to:** + Review, research, process, and adjust claims accurately. + Handle claim adjustment work including Calltraks/Onbase. + Process ... **Adecco is assisting a local client in recruiting for Claims Representative opportunities in San Juan, PR.** This is...Onsite work model + Weekly paycheck + Dedicated Onboarding Specialist & Recruiter + Access to Adecco's Aspire Academy… more
- MyFlorida (Tallahassee, FL)
- …for authorizing and making offers of settlement up to approved authority and denying claims when necessary. Responsible for the adjustment and recording of claim ... RISK MANAGEMENT PROGRAM SPECIALIST - 43001345 Date: Sep 24, 2025 The...DIVISION OF RISK MANAGEMENT BUREAU: STATE LIABILITY AND PROPERTY CLAIMS CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: Requirements: +… more
- Washington Metropolitan Area Transit Authority (New Carrollton, MD)
- Benefits Specialist Job ID: 250824 Location: MD-Metro Bldg New Carrollton Full/Part Time: Full-Time Posting Open-Close 09/24/2025 - 10/07/2025 Union NRP ... Area Transit Authority (WMATA) Benefits Department is seeking a Benefits Specialist who will be responsible for benefits and retirement administration for… more
- Travelers Insurance Company (Houston, TX)
- …to join our Strategic Resolution Group Claim team as a Major Case Specialist handling complex toxic tort, latent injury, sexual misconduct, environmental claims ... will independently manage our most challenging high frequency and high severity claims and accounts which routinely present unique, complex liability and coverage… more
- Aston Carter (Naperville, IL)
- Job Title: Provider Operations Specialist Job Description We are seeking a dedicated Provider Operations Specialist to join our dynamic team. The role involves ... daily interactions with providers and overseeing service request hubs, including emergency claims . You will play a crucial role in ensuring smooth provider… more
- Pfizer (Memphis, TN)
- …Pfizer's supply chain and customer operations team as necessary. + Research complex claims . Work collaboratively with customers , deduction specialist and the ... **ROLE SUMMARY** The Customer Account Specialist is the positive Pfizer face to Pfizer's...line, and works to quickly resolve any distribution related claims . Position handles incoming calls and request from customers… more
- Travelers Insurance Company (Indianapolis, IN)
- …join our Strategic Resolution Group Claim team as a Sr. Technical Specialist handling complex toxic tort, latent injury, sexual misconduct, environmental claims ... exposures. With general supervision, you will manage challenging large exposure claims which routinely present unique, complex liability and coverage issues. You… more
- Travelers Insurance Company (Orlando, 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 (New York, NY)
- …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 (Downers Grove, IL)
- …and resolving assigned General Liability related 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 severe claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary + The Accounts Receivable Specialist role and responsibilities include: monitoring all aspects of the collection of outstanding debts owed to the ... accounts including drafting and submitting technical appeals. In addition, the AR specialist is the subject matter expert for all billing staff regarding insurance… more
- CareFirst (Baltimore, MD)
- …capture and proper use of CPT, HCPCS, and ICD 10 codes in claims submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting ... models. Strategizes alternatives and solutions to maximize quality payments and risk adjustment . Translates from claim language to services in an episode or… more
- Geisinger (Danville, PA)
- …a portfolio of accounts consisting of accounts per Revenue Management Service Line Specialist and/or the processing of claims . + Performs hospital and ... join our team in the role of Service Line Specialist Senior - Revenue Management. The position will involve...charge entry, diagnosis coding, and billing for ground ambulance claims . The ideal candidate will also be responsible for… more
