• Risk Management Specialist

    City of College Station (College Station, TX)
    …thorough and sufficient supporting evidence. + Maintain accurate and complete claims records, including entering incident reports, assigning claim numbers, ... and tracking the progress of each claim . Manage claim status notifications and coordinate the processing of related invoices to ensure timely and efficient … more
    City of College Station (10/22/25)
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  • Disability Representative Sr.

    Sedgwick (Irving, TX)
    …system documentation.** **Coordinates investigative efforts to ensure thorough and appropriate claim reviews.** **Identifies when claims require external support ... **_caring counts-and so do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise, and impact. Right now,… more
    Sedgwick (10/01/25)
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  • Reinsurance Auditor

    GE Aerospace (Houston, TX)
    …Microsoft Office Suite and ability to navigate other business-related software, including claim processing systems and applications. + Excellent written and oral ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
    GE Aerospace (11/06/25)
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  • Specialist, Appeals & Grievances - Remote ( Must…

    Molina Healthcare (Dallas, TX)
    …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
    Molina Healthcare (11/23/25)
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  • Disability Representative

    Sedgwick (Irving, TX)
    …Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims . **ARE YOU AN IDEAL CANDIDATE?** We are looking ... naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes… more
    Sedgwick (11/14/25)
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  • ADA Accommodation Coordinator

    Sedgwick (Irving, TX)
    …federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to… more
    Sedgwick (10/24/25)
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  • Pharmacy Coordinator

    Highmark Health (Austin, TX)
    …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… more
    Highmark Health (11/26/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Austin, TX)
    …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with… more
    Cardinal Health (11/20/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Fort Worth, TX)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments...years operational managed care experience (call center, appeals or claims environment). + Health claims processing… more
    Molina Healthcare (11/07/25)
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  • Senior QNXT Analyst - Contract Configuration

    Molina Healthcare (San Antonio, TX)
    …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
    Molina Healthcare (10/01/25)
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