Title: Revenue Cycle Specialist | Revenue Cycle Location: FL, GA, MO, PA, SC, NC, TN, or TX Job Description: - Office and Clerical - 61666 Job Description Overview Remote flexibility meets meaningful healthcare impact in this Transplant Charge Review Analyst opportunity. Work Style: Remote Location Requirement: Must reside in an authorized state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and audits all inpatient and outpatient pre-transplant charges to ensure accuracy, compliance, and proper classification. Verifies that both transplant and non-transplant related charges are processed and recorded appropriately in alignment with corporate policies and governmental regulations. Supports the accuracy of the annual Medicare Cost Report by ensuring charge integrity and compliance with reporting requirements. Identifies discrepancies, performs detailed analysis, and collaborates with clinical, billing, and finance teams to resolve issues and improve processes. Plays a critical role in maintaining financial accuracy, regulatory compliance, and operational efficiency within transplant-related revenue cycle activities. Responsibilities Key Responsibilities - Reviews charge work queues for transplant and donor patient hospital and professional charges across all organ programs - Identifies, tracks, and resolves missing or misrouted charges in collaboration with Coding, Patient Financial Services (PFS), and clinical departments - Assists with preparation of audit documentation for Medicare Cost Reports and other regulatory submissions, as needed - Participates in cross-functional meetings and supports Charge Capture Review Team initiatives - Collaborates with IT analysts and Epic teams to optimize charge capture tools and workflows within Epic - Partners with Transplant Financial Coordinators and Transplant Nurse Coordinators to verify transplant phase, as needed Qualifications Minimum Qualifications - Minimum of two (2) years of experience in healthcare revenue cycle, charge capture, coding, or transplant operations - Active nursing license or coding certification (e.g., CCS, RHIT, RHIA, CPC, COC, CIC, or CCS-P) - Proficiency in revenue integrity, billing, and audit tools; experience with EHR systems (Epic preferred) - Working knowledge of transplant billing and compliance requirements - Demonstrated ability in process improvement and problem-solving within complex healthcare environments - Experience with clinical chart review and data abstraction

Title: Claims Resolution Specialist - Special Risk Policyholders Location: Phoenix United States Job Description: Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best "A" (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a WC Claims Resolution Specialist - Special Risk Policyholders. This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise. This role requires Arizona expertise, and ideally Utah, Texas and Colorado. The ideal candidate will possess the following skill set. Summary Statement Manage workers' compensation claims for insureds with loss-sensitive insurance programs, such as large deductibles and retrospectively rated policies. Conducts thorough investigations, evaluates claims, and ensures effective resolution while delivering exceptional customer service to insureds with loss sensitive insurance policies. Builds robust relationships by demonstrating strong analytical, negotiation, and communication skills, with a focus on delivering quality claim outcomes and excellent service. Essential Tasks/Major Duties - Investigate losses, determine coverage, assess compensability, and review and analyze documents and legal pleadings. - Collaborate with legal counsel to manage litigated claims, leveraging experience to analyze documents and legal proceedings effectively. - Develop and execute proactive claim resolution strategies, including timely damage evaluations, negotiations, and settlements in accordance with guidelines. - Establish and maintain accurate claim reserves to reflect financial exposure, ensuring clear and proactive communication with the insured regarding rationale and potential impact. - Identify and engage external resources as needed to facilitate proper claim resolutions while monitoring and controlling costs. - Partner with insureds, medical providers, and injured workers to facilitate a safe and timely return to work when appropriate. - Collaborate proactively with agents, policyholders, and internal stakeholders to analyze claims trends, implement risk mitigation strategies, and provide claims education. - Prepare and deliver detailed claim summaries, reserve updates, and other analyses for agents and insureds. - Understand and assess loss-sensitive insurance programs, such as large deductible or retrospectively rated policies, keeping insureds informed of financial implications. - Mentor and train other claims handlers. Knowledge, Skills & Abilities - Bachelor's degree or equivalent combination of education and experience. - 5 years of experience handling workers' compensation claims of medium to high level of severity/complexity. - Ability to obtain appropriate state licensing as required. - Proficient computer skills required including Microsoft Office Suite. - Demonstrated ability to build positive relationships and partnerships within department, across the organization and with external customers. - Strong analytical skills and attention to detail. - Excellent verbal and written communication skills with the ability to interact with internal and external customers. - Ability to travel overnight up to 15%. #LI-Remote Just as we are committed to creating exceptional value for our Partners For Success agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine's Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you. Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer. Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws. Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination. Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices. Any improper interference with an employee's ability to perform their job duties may result in disciplinary action, up to and including termination.

Title: Senior Workers' Compensation Claims Adjuster Location: Phoenix United States Job Description: Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best "A" (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Senior Workers' Compensation Claims Adjuster. This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise. This role requires Arizona expertise, and ideally Utah, Texas and Colorado. The ideal candidate will possess the following skill set. Summary Statement Provides quality investigation and analysis to adjust claims of medium complexity/severity, including litigated files, to proper resolution. Promotes the success of the organization through development of relationships with agencies, policyholders and employees. Essential Tasks/Major Duties - Collaborate and communicate with agents, policyholders and internal stakeholders on claims of medium complexity/severity and book of business. - Investigate losses, identify coverage, determine compensability, review and analyze documents and legal pleadings. - Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines. - Establish and maintain proper reserves for each claim to accurately reflect the financial exposure. - Determine need for, identify and engage external resources as needed to execute proper resolutions while monitoring and controlling costs. - Collaborate with counsel to manage litigated claims. - Review and interpret commercial insurance policies and accordingly communicate coverage issues verbally and in writing. Knowledge, Skills & Abilities - Bachelor's degree or equivalent combination of education. - 3 years of experience handling workers' compensation indemnity claims of medium level of complexity/severity. - AIC or SLA certification preferred. - Ability to obtain appropriate state licensing as required. - Proficient computer skills required including Microsoft Office Suite. - Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers. - Strong analytical skills and attention to detail. - Excellent verbal and written communication skills with the ability to interact with internal and external customers. - Ability to travel overnight up to 10% - Ability to travel daily between locations. #LI-Remote Just as we are committed to creating exceptional value for our Partners For Success agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine's Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you. Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer. Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws. Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination. Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices. Any improper interference with an employee's ability to perform their job duties may result in disciplinary action, up to and including termination.

Title: Senior Claims Specialist Location: remote United States Job Description: Job Category Claims Subcategory Casualty Claims Typical Starting Salary $77,300 to $102,500 Minimum Salary $67,000.00 Maximum Salary $126,000.00 Schedule Full-Time Flexible Time Off Annual Accrual - days 15 Description The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads. This is a remote position. You will be required to go into the office twice a month if you reside within 50 miles of Hoffman Estate, IL and Plano, TX. Please note this policy is subject to change. Responsibilities: - Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate. - Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim. - Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. - Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company. - Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process. - Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews. - Performs other duties as assigned. Qualifications - Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required. - Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively. - Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience. - Required to obtain and maintain all applicable licenses. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.