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- ...Job Description Job Description Job Title: Director of Risk Adjustment and Quality Department: Risk Adjustment & Quality Product... ...risk arrangements. - Lead internal teams including clinical coders, quality analysts, and client success staff focused on risk and...Risk
Lightbeam Health Solutions
Dallas, TX8 days ago $19.6 per hour
...Responsibilities As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses... ...system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in...RiskRemote jobFull timeWork at officeFlexible hours- ...We are actively seeking a Product Manager – Risk Adjustment to lead the design, delivery, and ongoing enhancement of our Risk Adjustment Analytics platform. This role is ideal for a proactive, data-driven leader with a strong grasp of Medicare Advantage and risk adjustment...RiskFull timeShift work
$77.97k - $171.06k
Overview Job Description Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources...RiskRemote jobWork experience placement$50k
...Description Job Description Senior Workers’ Compensation Claims Adjuster · Texas Claims Experience A Must · Texas Adjusters License... ...and benefits package. Company Description North American Risk Services (NARS) is a premier third-party claims administrator...RiskWork at officeWork from homeNorth American Risk Services, Inc. (NARS)
Dallas, TX3 days ago- ...Job Description Job Description Corporate Insurance Risk Manager Pillar Income Asset Management, Inc. is seeking a Corporate... ...industry and macroeconomic trends to proactively mitigate risk and adjust insurance program structures. Educate business units on...RiskContract work
Premier Payroll Administration
Dallas, TX19 days ago - ...pursuing another professional insurance designation. Appropriate state adjuster license is required. Experience Five (5) years of related... ...candidate for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskWork at office
- ...Best Workplaces in Financial Services & Insurance (Remote) Claims Adjuster - Workers Compensation | Midwest & Southeast Jurisdictions Are... ...for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskRemote jobWork at officeFlexible hours
$60k - $65k
...Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you’ll... ...for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskLocal areaWork from homeFlexible hours- ...Financial Services & Insurance Commercial Property Claims Desk Adjuster - Remote after training PRIMARY PURPOSE : Handles losses and claims... ...for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskRemote jobWork at officeLocal area
- ...to be a trusted advisor both internally and to the client. # Risk Management and new loan originations: Work closely with credit... ...whether it’s a service problem, a financial solution that needs adjusting, or an operational concern. # Compliance and Documentation :...RiskFull timeWork experience placementWork at officeMonday to Friday
THIRD COAST BANK
Dallas, TX28 days ago - ...development. This role involves drafting and negotiating complex legal documents, conducting due diligence, and advising clients on legal risks and compliance issues associated with commercial property matters. Duties : Candidates should possess experience in...RiskWork at officeRemote work
Trigild
Dallas, TXa month ago $95k - $140k
Senior Liability Adjuster - NY Labor Law Join to apply for the Senior Liability Adjuster - NY Labor Law role at Berkshire Hathaway GUARD... ...contracts and insurance policies to identify coverage issues and risk transfer strategies. Proactively negotiate claims to achieve favorable...RiskFull timeWork at officeRemote work3 days per week- ...Job Description Job Description Job Summary: The Clinical Risk Specialist focuses on reviewing and analyzing medical record... ...the Claim Payment Integrity Review (CPIR) report utilized for adjusted claim payments by clients. Collaborate with other teams to ensure...RiskWork at officeLocal area
Catalyst Clinical Coding and Analytics
Dallas, TX10 days ago - ...candidate for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive... ...sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000...RiskFull timeWork at officeLocal area
$77.97k - $155.51k
...Design scalable workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity. Technology... ...change management (training, SOPs, job aids, communications). Risk, Compliance & Quality: Ensure alignment to CMS, HIPAA, state regulations...RiskWork experience placement$77.97k - $155.51k
Job Description Job Summary The Risk & Quality Performance Manager position will support Molina’s Risk & Quality Solutions (RQS) team... ...years of program and/or project management experience in risk adjustment and/or quality 2+ years of experience supporting HEDIS engine...RiskWork experience placementWork at office- ...stakeholders, addressing performance metrics and strategizing adjustments to meet lender requirements if required. Resident Experience... ...fostering a culture of high performance and accountability. Risk Management & Compliance Ensure compliance with local regulations...RiskFull timeWork at officeLocal area
Mapletree
Dallas, TX2 days ago - ...pursuing another professional insurance designation. Appropriate state adjuster license is required. Experience Five (5) years of related... ...candidate for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskWork at officeLocal areaFlexible hours
- ...Risk Management Specialist Under general direction of the Sr Risk Management Services Manager or Sr Enterprise Risk Management... ...including conducting site visit and/or investigations with insurance adjusters. Supports the analytics: trending of incident and claims to...RiskContract workFor contractors
- ...Best Workplaces in Financial Services & Insurance National General Adjuster - Southwest Region PRIMARY PURPOSE : To handle losses or claims... ...for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by...RiskWork at officeLocal areaFlexible hours
- ...statements of individuals and/or firms to determine the degree of risk involved by performing the following duties for the preparation... ...required by this job include close vision and ability to adjust focus. Work Environment The work environment characteristics described...RiskContract workWork at officeLocal areaRemote work
- ...,200+ professionals across our 14 offices in 8 countries. Client X provides fund administration, middle office services, integrated risk & portfolio management, regulatory & compliance reporting, tax support, and complete shadow accounting services, underpinned by SOC...RiskWork at officeFlexible hours
The Rockridge Group
Dallas, TX3 days ago - ...ownership of business goals and targets and ensure they are met. In-depth understanding of regulatory compliance, with experience in risk management within debt recovery operations. Strong people skills to build and maintain relationships with clients, stakeholders,...RiskWork at office
Credence Global Solutions
Dallas, TX11 days ago $100k - $150k
Join to apply for the Insurance Risk Management Specialist role at Axis Energy Services . Get AI-powered advice on this job and more... ...to legal and senior management on a weekly basis. Work with adjusters in various states regarding claims. Assist HSE, HR, and adjusters...RiskFull timeImmediate start- ...in C/C++, Python3, QNX, and Linux. Monitor project progress and adjust plans as necessary to meet deadlines. Ensure that all projects are... .... Report and escalate to management as needed. Perform risk management to minimize project risks. Establish and maintain relationships...RiskWork at officeRemote work
$62.4k
...experience with a strong understanding of consumer compliance requirements. You will gain direct knowledge of regulatory obligations, risk management practices, and compliance related functions such as monitoring, advisory, testing, and analytics. You will discover how...RiskHourly payContract workTemporary workInternshipSummer internshipWork at officeRelocation packageSantander Holdings USA Inc
Dallas, TX3 days ago- ...candidate will build and maintain confidence with customer, identify risk and mitigate it accordingly. Outcomes 95%+ achievement of all... ...budgets and forecasts, with the ability to track, manage, and adjust spend as programs progress. Communication Skills - Capable of conveying...RiskFull time
- ...Purpose This critical role combines clinical nursing expertise with risk management responsibilities to protect our organization and... ...accurate and timely processing Coordinate with insurance adjusters and carriers throughout the claims process Prepare comprehensive...RiskWork at office
- ...experience, making banking easy in an omni channel environment. Collaborates with a broad range of eco-system partners. Accountable for risk management and compliance . Builds a high performing team through the attraction, on-boarding, coaching and development of branch...RiskFull timeTemporary workPart timeWork experience placementWork at office
