- Allied Universal (San Antonio, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- Kemper (Dallas, TX)
- …Specialist will investigate, evaluate and handle to conclusion all assigned litigated claims . The Litigation Specialist will have advanced claim handling skills ... and be able to effectively manage the litigation claim process. Open positions in several office locations, Birmingham,...legal budget process. + Successfully evaluate coverage or liability claims investigation. + Evaluate injury claims and… more
- USAA (Houston, TX)
- …accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge ... and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes… more
- Rush Enterprises (New Braunfels, TX)
- …as individual claims required. + Perform regular audits of individual claim files and review workers' compensation claims . + Efficiently manage caseload ... services. Responsibilities + Oversee and manage complex workers compensation claim process, including reporting, medical coordination, lost time and return-to-work… more
- CVS Health (Austin, TX)
- … * Follow validation instructions provided by our constituents to properly review ACAS claims for overpayment * Utilize GPS for claim review * Utilize SCM ... This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and...experience along with provided guidance to review and validate claims for overpayment. The ideal candidate will be able… more
- Sedgwick (Irving, TX)
- …CA 91304 **PRIMARY PURPOSE** : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan ... and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations;… more
- Sedgwick (Irving, TX)
- …Sr **PRIMARY PURPOSE** : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan ... and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations;… more
- Methodist Health System (Dallas, TX)
- …to resubmit claims promptly and accurately. - Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical coding guidelines, and ... background in A/R follow up for family and specialty claims , able to identify, address, and resolve no response...Detail-oriented with a focus on accuracy and thoroughness in claim analysis, documentation, and reporting. - Ability to prioritize… more
- Houston Methodist (Houston, TX)
- …clinical knowledge to reduce financial risk and exposure caused by front end claim edits and retrospective denial of payments for services provided. This position ... revenue cycle personnel, and payers to successfully clear front end claim edits, appeal clinical denials, and address customer service inquiries. Additionally,… more
- Molina Healthcare (TX)
- …execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as ... Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate payment levels, optimize resource utilization,… more