- CVS Health (Austin, TX)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... Explain provider's rights and responsibilities in accordance with contract. + Process claim referrals, new claim handoffs, nurse reviews, provider complaints,… more
- USAA (San Antonio, TX)
- …coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable ... procedures for business activities. + Adjusts non-attorney involved soft tissue bodily injury claims , as well as all auto physical damage associated with those … more
- Toyota (Plano, TX)
- …of any materials for presentation to various audiences. + Manage insurance program claims activities (ie, collection of claim detail information from business ... North American region, processing insurance requests, creating/updating analytical reports, claims management, providing risk management support, and consultation to… more
- Sedgwick (Houston, TX)
- …Adjuster - Power/Energy (SE & SW Regions) **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other companies ... including handling accounting-based losses (business interruption and stock). + Examines claim form and other records to determine insurance coverage. + Interviews,… more
- Sedgwick (Dallas, TX)
- …Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... including handling accounting-based losses (business interruption and stock). + Examines claim forms and other records to determine insurance coverage. + Interviews,… more
- Molina Healthcare (San Antonio, TX)
- …Resolves and prepares written response to incoming provider reconsideration requests relating to claims payment and requests for claim adjustments or to requests ... narratives, graphs, flowcharts, etc. for use in presentations and audits. Researches claims appeals and grievances using support systems to determine appeal and… more
- Molina Healthcare (Austin, TX)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- Cardinal Health (Austin, TX)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Molina Healthcare (San Antonio, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Southland Holdings (Grapevine, TX)
- …strategic thinking, and problem-solving skills. The manager supports dispute resolution, claims , and contract compliance, serving as a trusted advisor to business ... responses. + Draft formal contract correspondence, including notices and claims , to protect company entitlements. + Collaborate with scheduling and… more