Health Claims & Risk Coordinator — Safeguard Quality
Hispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement seeks a Risk Coordinator in North Carolina to support the general liability claims process. In this role, you will help claims examiners with investigations, preserve evidence, and manage claims documentation effectively. The ideal candidate will demonstrate proficiency in Microsoft applications and possess strong analytical, organizational, and communication skills. Join us in contributing to a more connected and compassionate health experience. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
- ...employers with self-funded health plans. Marpai... ...proactively targets at-risk members with meaningful... ...The Client Experience Coordinator is responsible for providing... ...Customer Service (CS), Claims and Account Leads Keep... ...consensus Commit to quality service Understand shared...QualityRiskClaimsRemote workFlexible hours
- Recovery Coordinator/Family Worker - Dual roleLocation: HMP... ...of the largest mental health and social support charities... ...processes such as risk assessments, risk management plans and safeguarding assessments and plans.This... ...and deliver quality programs and packages of...QualityRiskFixed term contractLocal area
- ...Overview Contentnea Health is a Community... ...Summary Leads the risk management initiatives... ...with the Quality Improvement (QI) Department... ...and initiatives. Safeguards the organization... ...PCMH), Federal Tort Claims Act (FTCA) and... ...and procedures in coordination with management to...QualityRiskClaimsLocal area
$140k - $160k
...mitigate PBM contractual guarantee risk. Rightway’s PBM business... ...using contract rules and claims-based spend clear views into... ...member-provided information (health profile submissions) Set standards... ...and trust: timeliness, data quality, explainability, and...QualityRiskClaimsContract workWork at officeRemote workNight shift$36.38 - $45.48 per hour
...Position Title LTSS Service Coordinator – RN Clinician (RN Case... ...by law. The MyCare Ohio health plan is to deliver high‑quality, trauma informed, culturally... ...members for high risk complications and coordinates... ...solving with providers, claims or service issues. Minimum...QualityRiskClaimsTemporary workWork at officeLocal area1 day per week- ...ID: 1134 The Corporate Safety/Risk Management Director serves as... ...risk management, insurance, and claims programs. Based in Raleigh, NC... ...effectiveness, productivity, quality, and project success. The... ...Construction Management, Occupational Health, Engineering, or related field...QualityRiskClaimsFull timeWork at officeLocal area
$54.1k - $155.54k
...re building a world of health around every individual... ...prioritize safety and quality in everything we do. Join... ...designed to reduce risk factors and barriers and... ...focus to benefit overall claim management. Using a... ...navigator or nurse care coordinator experience as well as experience...QualityRiskClaimsHourly payFull timeLocal areaRemote workWork from homeFlexible hours- Department: College of Pharmacy & Health Sciences Status: Full Time... ...Summary The Student Affairs Coordinator is a key member of the Office... ...measures to evaluate quality and effectiveness of the academic... ...available tools to track at‑risk student populations, report developing...QualityRiskFull timeApprenticeshipSummer workWork at officeLocal area
- ...serving employers with self-funded health plans. Marpai Administrators (... ...Marpai proactively targets at-risk members with meaningful... ...ABOUT THE POSITION: The Claims Processor will be responsible... ...Meet departmental standards for quality, production and attendance....QualityRiskClaimsRemote workFlexible hours
- ...Overview Lyra Health is the leading provider of mental health solutions... ...in overall healthcare‑claims costs. Lyra is transforming access... ...platform combining the highest‑quality care and technology solutions.... ...area Experience managing risk and responding to clinical crises...QualityRiskClaimsFull timeContract workFor contractorsPrivate practiceWork at office
- ...the Department of Behavioral Health at the Womack Army Medical Center... ...centers, daycare, star-quality dining, full service banking,... ...studies, utilization review, risk management, and peer review activities... ...covered by the Federal Tort Claims Act (28 U.S.C. § 1346(b)) while...QualityRiskClaimsPermanent employmentTemporary work
$22.3 - $35.2 per hour
...Lead Coordinator, Collections About Navista We believe... ...to Cardinal Health Finance oversees the... ...financial systems and safeguards the organization's assets... ...timely processing of claims, including denials and... ...with credit analysis and risk assessment. What...RiskClaimsHourly payTemporary workWork at officeLocal areaImmediate startFlexible hours- ...manner, meeting the diverse health and social needs of the... ...the Dentists to take quality x‑rays and assist the... ...need and caries risk recalls in accordance with... ...relates to oral health. Coordinates hygiene recalls based on... ...at risk for fraudulent claims, resulting in loss of agency...QualityRiskClaimsTemporary workLocal area
- ...business insurance, employee health & benefits, retirement, and private... ...ensure placements meet agency quality and service standards. Our... ...science, engineering, math, and/or risk management/insurance is... ...consulting, loss control, or claims) with demonstrable experience...QualityRiskClaimsLocal areaFlexible hours
$17 - $34.15 per hour
...re building a world of health around every individual... ...prioritize safety and quality in everything we do. Join... ...Part B Operations Coordinator is responsible for supporting... ...to‑end Medicare Part B claims processing activities.... ...debt, mitigate legal risk and ensure compliance with...QualityRiskClaimsFull timeLocal area$150.03k - $224.25k
...clinical studies, including coordination with other relevant... ..., timeliness and quality of the TMF. • Serve... ...Participate in program-level risk mitigation strategies... ...fee, even if claimed you will be reimbursed... ...and Otsuka Precision Health, Inc. (“Otsuka”) does...QualityRiskClaimsContract workTemporary workLocal areaFlexible hours$100.1k - $166.9k
...products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well‑being of... ..., authorization middleware, claims transformation, and access policy... ...Security on threat modeling, risk reviews, and secure SDLC...QualityRiskClaims$99k - $124k
...ll Make An Impact At Strive Health, patients come first. We’re... ...conditions by identifying risk earlier, coordinating thoughtful care, and supporting... ...without compromising quality. Comfortable navigating ambiguity... ..., MOR, MAO-004 and medical claims data. High degree of...QualityRiskClaimsWork at officeRemote workWork from homeFlexible hours- ...plans and perform regulatory risk management ensuring operational... ...Responsibilities Responsible for quality of resident care and develops,... ...that promotes optimum health care delivery. Stay abreast of... ...reporting and workers compensation claims. Prepare applicable documentation...QualityRiskClaimsFull timeWork at officeLocal areaFlexible hours
$209.6k - $313.38k
...mechanistic rationale, benefit-risk, and clinical unmet... ...and present decision-quality data packages for... ...Demonstrated ability to coordinate and guide cross-functional... ...processing fee, even if claimed you will be reimbursed,... ..., and Otsuka Precision Health, Inc. (“Otsuka”) does...QualityRiskClaimsTemporary workLocal areaFlexible hours$67.9k - $199.14k
We're building a world of health around every individual—shaping a... ...accountable, and prioritize safety and quality in everything we do. Join us... ...Manager to join our dynamic Risk Adjustment Analytics team! In... ...medical and pharmacy claims, encounter, provider, and membership...QualityRiskClaimsRemote jobHourly payFull timeTemporary workWork experience placementLocal area- Client Manager, Employee Health & Benefits Join to... ...complex issues related to claims, billing, and eligibility... ...meeting agendas, and coordinating plan documents will be... ...required Working knowledge of risk management techniques,... ..., Fenton Client Quality Manager Stars and Quality...QualityRiskClaimsPermanent employmentFull timeWork experience placementWork at officeLocal areaRemote workNight shift
$69.85k - $97.09k
...healthcare analytics and technology company that helps health plans and at‑risk providers improve Risk Adjustment and Quality outcomes across HIX, Medicare Advantage, and... ...financial impact. Analyze and reconcile claims and encounter data which will include 837 EDI encounter...QualityRiskClaimsFor contractorsLocal areaRemote work- At Duke Health, we're driven by a commitment... ...Team Lead, in coordination with the Service Access... ...and waiting areas safeguard patient privacy,... ...the constraints and risks associated with... ...adherence and high quality outcomes. Actively... ...Review, PB and HB Claim Edits, to identify...QualityRiskClaimsFlexible hoursAfternoon shift
$67.9k - $182.55k
We’re building a world of health around every individual - shaping... ...accountable and prioritize safety and quality in everything we do. Join us... ...Group division, managing risk evaluation and financial performance... ...earned premium and incurred claims. Approves medical...QualityRiskClaimsHourly payFull timeTemporary workLocal area$66.33k - $145.86k
...4485We’re building a world of health around every individual — shaping... ...and prioritize safety and quality in everything we do. Join us and... ...reporting* Identify trends, risks, and opportunities to improve... ...with large, complex datasets (claims, provider, or healthcare data...QualityRiskClaimsHourly payFull timeTemporary workLocal areaWork from home$186.49k - $278.88k
...clinical programs, including coordination with other relevant... .../CTA annual reports, Health Authority briefing... ...to optimize scientific quality/innovation of clinical... ...Participate in program-level risk mitigation activities.... ...fee, even if claimed you will be reimbursed...QualityRiskClaimsContract workTemporary workLocal areaFlexible hours$67.9k - $182.55k
...re building a world of health around every... ...prioritize safety and quality in everything we do. Join... ..., digital engagement, claims, and financial administration... ...proactively manage risks and dependencies, providing... ...sequencing and coordinating feature‑level execution...QualityRiskClaimsHourly payFull timeTemporary workWork experience placementWork at officeLocal area- Senior Director Health Economics Outcomes Research Location: NC-RTP... ...a trusted advisor on program risk, opportunity, and strategic trade... ...RWE standards, processes, and quality frameworks to ensure... ...patterns, PRO/COA, registries, claims/EHR analyses, and economic models...QualityRiskClaimsFull timeContract workWork at office
$100 per hour
...Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive... ...when appropriate Care Coordination & Quality Support Identify clinically... ...to HIPAA regulations and safeguard protected health information...QualityRiskReliefImmediate startFlexible hoursWeekday work
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