- USAA (Dallas, TX)
- …accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge ... and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes… more
- Sedgwick (Irving, TX)
- …efforts to ensure thorough and appropriate claim reviews.** **Identifies when claims require external support and arranges referrals to vendors for services ... **_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 (Austin, TX)
- …ensure accurate and sufficient information is received by employees and providers to support the claim request and documents decision rationale. + Completes ... of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for… more
- Houston Methodist (Houston, TX)
- …medical records to verify and substantiate diagnosis and procedures for charge review, claim edit(s) and/or denied claims and submits clinical appeal or ... physician record and reviews and corrects charge review and claim edit related coding errors in the electronic health...with management on coding and diagnosis issues to reduce claims denials by providing verbal and written communication. +… more
- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal ... care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in… more
- CDM Smith (Fort Worth, TX)
- …and Evidence Gathering: Collect and organize all necessary documentation to support claim amounts. This includes gathering invoices, receipts, contracts, ... Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related… more
- Rexel USA (Dallas, TX)
- …compensation claims + Liaise with National Safety Manager on Workers Compensation claims analysis in support of Safety and prevention initiatives and OSHA ... and processes to control the cost of insurance and claims . **What You'll Do:** + Provide best practices in...Legal, Outside Counsel, and Finance + Participate in quarterly claim reviews and best practice audits with Third Party… more
- USAA (San Antonio, TX)
- …of liability, setting and managing services throughout life of the claim while providing excellent service. Within defined guidelines and framework, you ... are responsible to adjust moderately complex auto insurance claims presented by or against our members to include...(now or in the future) you will need immigration support (ie, H-1B, TN, STEM OPT Training Plans, etc.).**… more
- Sedgwick (Irving, TX)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability...curriculum. + An assigned mentor and manager that will support and guide you on your career journey. +… more
- Molina Healthcare (San Antonio, TX)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution ... agencies to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate… more