- The Hartford (San Antonio, TX)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim...within the US and work their own time zone hours . Start Date: Open Hours : 8:00 AM-… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Work hours will be 7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various healthcare Healthcare claim audits including, ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- CVS Health (TX)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Molina Healthcare (San Antonio, TX)
- …to providers. **Job Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which ... United States. Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work...schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical… more
- Cognizant (Austin, TX)
- …regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing ... 6 weeks. This is a work-from-home position with day hours , and no travel is required. This position requires...information, and updating information to claim file about claims … more
- IQVIA (Houston, TX)
- …responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should ... **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location...documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining… more
- Mass Markets (Killeen, TX)
- …hear from you. This role involves handling inbound communications, evaluating warranty claims , and working closely with customers and service partners to ensure ... - Friday Off) + Must be available for weekends-shift hours and days cannot be modified. + Full-time, 40...inbound calls and email. + Evaluate and process warranty claims with precision, ensuring adherence to policy terms and… more
- CRC Insurance Services, Inc. (Flower Mound, TX)
- …for coverage; working with the insured, outside adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports ... then hire attorney for coverage counsel for coverage analysis. 2. Settle claims within settlement authority, where applicable. 3. Work with adjusters, insureds,… more
- Zurich NA (Addison, TX)
- …match and an additional 401K contribution, flexible work options, work/life balance, summer hours and a great culture. The Claims Professional will handle ... Legal Claims Professional - Financial Lines 126698 Zurich is...rights and coverage denial letters + Notify Underwriter of claim issues + Draft case summary reports in connection… more
- WTW (Dallas, TX)
- …administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will ... work + Develop working relationship with vendor counterparts + Distribute individual claim /work queues to team in a timely manner + Efficiently utilize… more
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