• Associate Specialist, Appeals & Grievances…

    Molina Healthcare (TX)
    …**KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation for further review. + Research issues ... utilizing systems and other available resources. + Assures timeliness and...**REQUIRED EXPERIENCE:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service… more
    Molina Healthcare (08/09/25)
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  • Analyst - Insurance Risk

    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
    Toyota (08/20/25)
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  • OSS Coordinator

    Sedgwick (Dallas, TX)
    …Services & Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; ... internal and external logins and the applicable security access for the company's claims management systems by determining the validity for incoming requests and… more
    Sedgwick (07/04/25)
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  • Surveillance Investigator

    Allied Universal (Houston, 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
    Allied Universal (08/23/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (TX)
    …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate ** position, you bring your **5 years of acute care inpatient coding… more
    Banner Health (06/15/25)
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  • Manager, Risk Management

    Community Health Systems (Lufkin, TX)
    …of safety and compliance. + Oversee the investigation and management of legal claims and suits, ensuring timely and accurate responses to legal inquiries and ... requirements. + Perform other duties as assigned. **Qualifications:** + Associate Degree required + Bachelor's Degree in Healthcare Administration, Nursing,… more
    Community Health Systems (08/20/25)
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  • Hotel Operations Manager (Bell & Valet Services)…

    Towne Park (Grapevine, TX)
    …client satisfaction objectives. **DUTIES AND RESPONSIBILITIES** **_Financial and Business Systems Management_** + Understands and drives business metrics and ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover + Manages scheduling, overtime for associates… more
    Towne Park (08/13/25)
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  • PCE Coordinator

    Baylor Scott & White Health (Temple, TX)
    …on position type and/or level **Job Summary** Manages detailed assessments of high-risk claims with a medical/legal plan to prevent claim elevation. Reviews and ... families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are:… more
    Baylor Scott & White Health (07/09/25)
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  • Coding Auditor Educator

    Highmark Health (Austin, TX)
    …and other related software. + Strong analytical and communication skills Preferred + Associate 's Degree + 3 years with claims processing and data management ... and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted...ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance… more
    Highmark Health (08/08/25)
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  • Human Resources Manager

    Omni Hotels (Houston, TX)
    …property, and enthusiastically promotes opportunities within the hotel and company. + Manages associate benefit file system to Omni Standard and ensures accurate ... Resources Department. + Participates in planning and execution of associate events planned by the Human Resources Department. +...enrollment for all eligible associates. + Monitor unemployment insurance claims and actively work to reduce claim more
    Omni Hotels (08/08/25)
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