Remote Hcc Risk Adjustment Coder Jobs in Louisiana

Under the direction of Risk Technical Services National Manager/Team Manager provides quality claims supervisory services and statistical data controls to the client or risk over field branch offices. Responsibilities include claim supervision of field adjusters, reserve controls, data corrections, data reviews to ensure accuracy, claim file reviews and audits, litigation management and rehabilitation evaluation, claim authorization of claim payments. Assist the Risk Technical Service (RTC) National Manager/Team Manager in maintenance of assigned accounts serving as corporate claim liason between branch office and client. Participate in the development of new accounts.

Why Crawford?

Because a claim is more than a number - it's a person, a child, a friend. It's anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.

At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We're looking for the next generation of leaders to take this journey with us.

We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.

When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer  a comprehensive Total Rewards package to  our employees  to assist with their financial, health/wellness, continuing education/training and other needs:

• Competitive base pay

- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. 

• Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
• We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:

- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include: - Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program

*The above information highlights some of the benefits currently available to eligible full-time employees.

• Training programs that promote continuous learning and career progression while enhancing job performance.
• Sustainability programs that give back to the communities in which we live and work.
• A culture of respect, collaboration, entrepreneurial spirit and inclusion.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

• Education equivalent to a college degree or the equivalent in related work experience.
• Five years previous experience as an adjuster or claim supervisor in various coverage
• Minimum of four years vocational preparation
• Demonstrated ability to supervise the work of others.
• Demonstrates effective and diplomatic oral and written communication skills, and promotes a favorable company image to the public.

#LI-EM3 #LI-REMOTE

• Review reportable claim files to ensure proper investigation.
• Review non-reportable file statistics via claim status sheets or other audit methods for proper data entry and collection.
• Evaluate claims from a legal, medical, and financial standpoint.
• Management of litigation by direction and supervision of work on claim files by defense counsel.
• Provide first-line supervision in support of same at branch level.
• Enforce reporting by field offices on claims reserved above authority levels in compliance with service standards and client requirements.
• Evaluate and authorize claims payments on reportable files.
• Troubleshoot coding errors.
• Review reporting level assignments within a reasonable time period.
• Review own diary in accordance with RTC service standards.
• Outline needed investigation on assignments; coordinate with client and RTC Manager/ Team Manager investigation procedures to be used by branches.
• Interpret and evaluate investigative material provided by branch, defense counsel, medical and technical services.
• Monitor and validate client data, selected claim listings, reserve exception reports, and client loss runs.
• Approve outgoing mail.
• Construct and maintain reference material.
• Assist in field branch office inspections.
• Assist Regional Directors and National Account Executives in transmitting and implementing client changes to programs.
• Retrieve files for audit purposes.
• Resolve coverage questions with clients.
• Carry out plans, programs and overall controls within the contract to client satisfaction.
• Coordinate and consult with client on claim activity; review with client reserves on reportable cases.
• Handle client complaints quickly and efficiently.
• Present adverse circumstances on a claim to client in an acceptable manner.
• Attend industry functions and uphold and project the professional image of the company to the industry.
• Comply with regulatory and licensing laws.
• Attend conferences and seminars and continue educational pursuits as part of self development.
• Uphold the "Statement of Principles" as adopted by the National Conference of Lawyers, Insurance companies and Adjusters, the Unfair Claim Practices Act of the NAIC and additional ethical standards of Crawford and Company.
• Be available upon request of Manager, Team Manager, Regionals, or clients to accept additional responsibilities when necessary