Remote Risk Adjustment Coding Jobs in Memphis, TN

Requirement/Must Have:

• Minimum 5 years of claims management experience.
• Strong expertise in general liability and professional liability claims handling.
• Experience managing complex and litigated claims.
• Knowledge of insurance principles, laws, and claim adjudication practices.
• Strong negotiation, analytical, and organizational skills.
• Proficiency with Microsoft Office products.
• Excellent written and verbal communication skills.

Experience:

• Five years of claims management experience or equivalent combination of education and experience required.
• Experience handling high exposure and litigated claims preferred.
• Experience with claims recoveries, subrogation, and reserve management preferred.

Responsibilities:

• Analyze and process complex or technically difficult general liability claims.
• Investigate and gather information to determine claim exposure and liability.
• Manage claims through detailed action plans to timely resolution.
• Assess liability and negotiate settlements within designated authority limits.
• Calculate and assign reserves and manage reserve adequacy throughout the claim lifecycle.
• Approve and process claim payments and adjustments.
• Prepare required state filings within statutory deadlines.
• Manage litigation processes and coordinate with legal and vendor partners.
• Utilize cost containment strategies and vendor partnerships to reduce claim costs.
• Manage claim recoveries including subrogation and applicable offsets.
• Communicate claim status and updates with claimants and clients.
• Ensure accurate claim documentation and coding.
• Support organizational quality programs and perform additional assigned duties.

Should Have:

• Professional certification related to claims or insurance preferred.
• Ability to work effectively in a team environment.
• Strong customer service and relationship management skills.
• Ability to meet or exceed service expectations.

Skills:

• General Liability Claims
• Professional Liability Claims
• Claims Investigation
• Litigation Management
• Claims Negotiation
• Reserve Management
• Subrogation
• Cost Containment
• Microsoft Office
• Analytical Skills
• Communication Skills
• Organizational Skills

Qualification and Education:

• Bachelor’s degree from an accredited college or university preferred.
• Professional certification applicable to line of business preferred.