- Towne Park (Canton, OH)
- …Ensures claims are reported timely and accurately and cooperates with the Risk Management department to resolve claims + Consistently follows the progressive ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover + Manages scheduling, overtime for associates… more
- Evolent (Columbus, OH)
- …You'll Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of the ... Risk Adjustment Coding Support team. Evolent Care Partners' mission...and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review. + Ensure… more
- Premier Health (Dayton, OH)
- 110 N MAIN ST, DAYTON, OH 45402 DEPT: GENERAL COUNSEL AND RISK MGMT Full-Time/ 8:00 AM - 5:00 PM **110 N. MAIN Street Dayton, OH 45402** **LOCAL CANDIDATES ONLY:** ... Health is looking for an experienced RN Nurse - Risk Manager to lead our Risk Management...exam. + Preferred: Background in professional nursing law or insurance/ claims + Strong leadership, analytical, and communication skills +… more
- Molina Healthcare (OH)
- …Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment ... to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment intervention ROI, incremental conditions captured, and other program… more
- Exl Service (Cincinnati, OH)
- Overview Commercial Insurance Risk Control Consultant - Independent Contractor Overview EXL Risk Control is a leading provider of risk assessments and loss ... insurance carrier and/or national broker in commercial Property & Casualty Risk Control, excellent communication skills, computer proficiency, and a commitment to… more
- Molina Healthcare (Dayton, OH)
- …codes are reported accurately to maintain compliance and to minimize risk and denials. **KNOWLEDGE/SKILLS/ABILITIES** + Performs on-going chart reviews and abstracts ... + Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk … more
- WTW (Cleveland, OH)
- …out prospects, calling on potential clients, conducting in depth needs analysis/ risk assessments, developing ideas for meeting their needs, presenting information on ... Align with individual client sales strategies. + Conduct thorough needs analysis/ risk assessment to uncover prospects/clients' unique coverage needs. + Provide… more
- Molina Healthcare (Akron, OH)
- …**Job Summary** This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- Molina Healthcare (Cincinnati, OH)
- …**Job Summary** The Junior Analyst will play a supporting role on the RADV ( Risk Adjustment Data Validation) team, assisting in the execution of CMS and internal ... confirm required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations, and clinical teams-to ensure accurate and consistent data… more
- Travelers Insurance Company (Cleveland, OH)
- …internal and/or external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and ... resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
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