Demonstrated experience using Xactimate to write, review, and edit property damage estimates ... Familiarity with Unfair/Fair Claims Practices and applicable insurance codes * Experience managing ...
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Demonstrated experience using Xactimate to write, review, and edit property damage estimates ... Familiarity with Unfair/Fair Claims Practices and applicable insurance codes * Experience managing ...
Claims Edit Coder information
What are the key skills and qualifications needed to thrive as a Claims Edit Coder, and why are they important?
To thrive as a Claims Edit Coder, you need a solid understanding of medical coding (ICD-10, CPT, HCPCS), claims processing, and healthcare regulations, typically supported by a coding certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, claims editing software, and payer-specific coding guidelines is crucial. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately identifying and resolving coding errors. These skills ensure correct claim submission, minimize denials, and support timely reimbursement for healthcare providers.
What are Claims Edit Coders?
Claims Edit Coders are healthcare professionals who review and analyze medical claims to ensure they are coded accurately and comply with insurance and regulatory guidelines. They use specialized coding systems, such as ICD-10, CPT, and HCPCS, to verify that procedures and diagnoses are properly documented. Their work helps prevent billing errors, reduce claim denials, and ensure timely reimbursement for healthcare providers. Claims Edit Coders often collaborate with billing departments and healthcare providers to resolve discrepancies and improve coding accuracy.
What is the difference between Claims Edit Coder vs Claims Processing Specialist?
| Aspect | Claims Edit Coder | Claims Processing Specialist |
|---|---|---|
| Certifications | Certified Coding Associate (CCA), CPC | None required, but certifications can be beneficial |
| Work Environment | Healthcare facilities, insurance companies, remote | Insurance companies, healthcare providers, office setting |
| Primary Responsibilities | Review and correct claim data, ensure coding accuracy | Process claims from submission to payment, handle inquiries |
Claims Edit Coders focus on reviewing and correcting claim data to ensure accurate coding, while Claims Processing Specialists handle the overall processing of claims from submission to resolution. Both roles require knowledge of insurance policies and coding, but Claims Edit Coders are more specialized in coding accuracy, whereas Claims Processing Specialists manage broader claim workflows.
What are some common challenges faced by a Claims Edit Coder, and how can they be addressed?
Claims Edit Coders often encounter challenges such as staying updated with frequent changes in coding regulations and payer-specific requirements. Additionally, coding errors or discrepancies may arise due to incomplete or unclear documentation from providers. To address these issues, it's important to engage in ongoing education, actively communicate with clinical staff for clarification, and utilize reliable coding resources and software. Collaboration with team members and regular training can help maintain accuracy and compliance in claim submissions.
What are popular job titles related to Claims Edit Coder jobs in Nebraska? For Claims Edit Coder jobs in Nebraska, the most frequently searched job titles are:
What job categories do people searching Claims Edit Coder jobs in Nebraska look for? The top searched job categories for Claims Edit Coder jobs in Nebraska are:
What cities in Nebraska are hiring for Claims Edit Coder jobs? Cities in Nebraska with the most Claims Edit Coder job openings:
Full-time
Posted 18 days ago
Job description
Property Claim Adjuster
Join a collaborative, service-focused team where attention to detail, professionalism, and customer care are valued. At Stillwater Insurance Group, you will play a critical role in supporting our Claims Department by ensuring accurate and timely claim intake while delivering exceptional service to policyholders and internal partners.
Why Stillwater?
Stillwater Insurance Group is a mid-sized national insurance provider offering home, auto, and commercial insurance products across all 50 states. Headquartered in Jacksonville, Florida, with offices in New York and Omaha, we are known for our supportive culture, strong values, and people-first approach.
Our employees consistently describe Stillwater as a place with great people, accessible leadership, and a genuine commitment to integrity. We emphasize teamwork, professional development, and internal growth within a positive, high-performing environment.
Role Overview
The Property Claim Adjuster is responsible for investigating, evaluating, negotiating, and resolving homeowner, dwelling, condominium, renters, and commercial property claims across our 50-state market. This is an in-office, desk-based role located in Jacksonville, FL. The position requires strong technical adjusting expertise, analytical capability, and the ability to manage complex coverage and damage determinations while delivering exceptional customer service.
Key Responsibilities
- Investigate and analyze property claims to determine coverage, liability, and damages
- Interpret and apply policy language accurately while protecting company rights
- Prepare professional correspondence including reservation of rights, non-waiver agreements, disclaimers, and coverage determination letters
- Communicate clearly and promptly with insureds, agents, contractors, public adjusters, attorneys, and internal stakeholders
- Utilize remote inspection tools and independent adjusters as appropriate
- Establish and maintain accurate claim documentation, file notes, and reserves
- Identify and pursue subrogation and salvage recovery opportunities
- Manage disputed claims including AOBs, CRNs, NOIs, and complex scope or pricing disputes
- Prepare detailed claim summaries and reports for management and regulatory purposes
- Create and audit property damage estimates using Xactimate; continuously refine estimating proficiency
- Ensure compliance with applicable state insurance laws, regulatory requirements, and internal claims handling standards
- Provide professional, solutions-focused customer service while effectively managing conflict
Minimum Qualifications
- 5+ years of property claim experience as an adjuster with an insurance carrier
- Bachelor’s degree (BA/BS/BBA) or equivalent combination of education and relevant experience
- Strong knowledge of property and casualty insurance policies and claims handling principles
- Demonstrated experience investigating and adjusting residential and/or commercial property claims
- Demonstrated experience using Xactimate to write, review, and edit property damage estimates.
- Strong analytical, investigative, and problem-solving skills
- Solid written and verbal communication skills
- Proficiency in Microsoft Office applications, including Excel
- Ability to manage multiple claims and competing priorities in a fast-paced environment
- Commitment to ethical standards, accuracy, and regulatory compliance
- Ability to maintain required adjuster licenses and continuing education
Preferred Qualifications
- Experience handling multi-state property claims
- Familiarity with Unfair/Fair Claims Practices and applicable insurance codes
- Experience managing litigated or complex property claims
Skills & Competencies
- Technical property damage assessment expertise
- Strong negotiation and conflict resolution skills
- High level of organization and file management discipline
- Sound judgment and coverage interpretation skills
- Collaborative team mindset
- Customer-focused approach balanced with risk management awareness
What You Can Expect
- A supportive, team-oriented culture
- Opportunities for cross-training and professional growth
- Recognition for accuracy, efficiency, and service excellence
- A workplace built on trust, integrity, and respect
Apply today to begin your career with Stillwater Insurance Group. Employment offers are contingent upon successful completion of a background investigation and pre-employment drug screening. Stillwater Insurance Group is a drug-free workplace and an equal opportunity employer.