- Sedgwick (Irving, TX)
- …needs. **PRIMARY PURPOSE** : Provides disability case management and routine claim determinations based on medical documentation and the applicable disability plan ... and making timely payments/approvals and adjustments, medically managing disability claims ; coordinates investigative efforts, thoroughly reviewing contested claims… more
- The Hartford (San Antonio, TX)
- …We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... the future. Sr. Performance Analytics Consultant, Auto & Property Claims Performance Analytics, The Hartford Reporting to the Director...labor and material costs, impact of storm intensity on claim severity, etc.) . Work as a thought-partner to… 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
- 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
- Sedgwick (Irving, TX)
- …system documentation.** **Coordinates investigative efforts to ensure thorough and appropriate claim reviews.** **Identifies when claims require external support ... : **At Sedgwick,** **caring counts** **. We're a global leader in claims management, and we're looking for experienced, compassionate professionals to join us… more
- Travelers Insurance Company (Austin, TX)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment… more
- Sedgwick (Austin, TX)
- …**PRIMARY PURPOSE** **:** Performs comprehensive reviews on personal and commercial lines claims of varying degree of severity (up to approximately $300,000) to ... quality of work product is delivered to our clients; confirm our adjuster's claim files comply with specific client handling guidelines and company standards;… more
- Sedgwick (Irving, TX)
- …questions and issues in accordance with designed guidelines and policies. + Communicates claims status and current claim activity with client and appropriate ... medical contact; responds to inquiries about jurisdiction- and claim -specific issues. + Enters data into claims system(s) and ensures claim files are… more
- CDM Smith (San Antonio, TX)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
- Highmark Health (Austin, TX)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... ** Company :** Highmark Inc. **Job Description :** **JOB...and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES**… more