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CPHRM (Certified Professional Healthcare Risk Management) or CPPS (Certified Professional Patient Safety required or within 2 years of hire. Masters degree education with relevant clinical experience and evidence of additional training in patient safety or risk management preferred.
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Resolves workers' compensation claims for closure; works closely with insurance adjusters (and organizational attorneys, if applicable). Knowledge of principles and practices of risk management activities such as risk identification/reduction, loss control, asset protection, employee safety, workers' compensation programs, etc.
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Preferred experience in compensation, benefits, leave, and support center or HR shared services model. They will oversee the strategic direction, administration, and delivery of compensation programs, the Employee Assistance Program (EAP), and the Employee Services shared service team to ensure a positive and employee-centric total rewards brand.
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Performs review of Risk Adjustment audits for accuracy and for data entry into the EMR.Utilizes nursing and coding knowledge to assist with review activities to support the Risk Adjustment process to include re-review of audit findings to ensure accuracy in documented HCC diagnoses and ICD-10 coding; review of various payer denial/rejection reports to identify areas for provider education.
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Avosys is seeking a Bexar County Remote Registered Nurse - Medical Review Specialist to work remotely to review Medicare claims. Perform clinical reviews of Medicare Part A and Part B claims for Medical Review, Redeterminations/Appeals (Appeals), and Prior Authorization requests (collectively, the Services) in accordance with CMS (Centers for Medicare & Medicaid Services) requirements.
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Strong engineering judgment and solid background in water resources projects Proficiency with MS Office Suite and Oracle-based ERP Project Financial Reporting System COMPENSATION The approximate compensation range for this position is $95,895 to $149,761.
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Azure Administrator Associate, Developer Associate, Deveops Solutions, Deveops Engineer Expert Cloud-Native Architectures Knowledge of Agile development methodologies Experience in Zero Trust ArchitecturesWhat we will provide in return: Excellent compensation and amazing benefitsMultiple health insurance options which include a PPO plan with ZERO deductibles and an HSA plan.
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This includes but is not limited to the model implementation, the model execution in the production environment, the process documentation and the conduction of related ad hoc analytics within the Quantitative Risk Management (QRM) framework under the supervision of manger or other senior stuffs.
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Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals.
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As a Property Adjuster Specialist you will work within defined guidelines and framework, investigates, evaluates, negotiates, and settles complex property insurance claims. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.
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What sets you apart: Financial Risk subject matter expertise – capital management, stress testing, liquidity and/or interest rate risk. Title: Audit DirectorLocation: Charlotte, NC (hybrid)As a dedicated Audit Director, you will manage the planning, execution and oversight of the consolidated annual audit plan including risk-based assurance and advisory engagements driving quality of audit work for a designated staff agency or line of business/functional area.
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Commercial Roofing Estimator Compensation: Strong base salary depending on experience. Commercial Roofing Estimator Compensation: Strong base salary depending on experience. Commission for profitability on projects Health and Dental benefits Company equipment Retirement options Apply today, be our next Commercial Roofing Estimator.
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Any other duties assigned by Maintenance / Refrigeration Manager BENEFITS: Health Insurance Life Insurance 401(k) Short Term Disability Paid Vacation& Sick leave Paid Holidays Cuisine Solutions is an Equal Opportunity Employer.
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The US Oncology Network is looking for an Insurance Authorization Specialist to join our team at Texas Oncology. Minimum three (3) years medical insurance verification and authorization and two (2) years clinical review experience required.
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Come be a part of what makes us so special As a dedicated Senior Property Adjuster, you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members.
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tpa compensation claims risk insurance jobs Company: Exxon in San Antonio, TX
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