- Kemper (Mcallen, TX)
- …is responsible for performance, development, coaching and also provides guidance and support to ensure timely, accurate, efficient claim processing and ... and settling claims in compliance with Kemper Claims Standards. + Responsible for oversight of claim... Claims Standards. + Responsible for oversight of claim files (non-litigated or litigated) within aligned unit to… more
- Sedgwick (San Antonio, TX)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- Sedgwick (Irving, TX)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more
- Sedgwick (Austin, TX)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor… more
- USAA (Houston, 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)
- …an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening ... Sr **PRIMARY PURPOSE** : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan… more
- Molina Healthcare (TX)
- …execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as ... Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate payment levels, optimize resource utilization,… 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 ... cycle personnel, and payers to successfully clear front end claim edits, appeal clinical denials, and address customer service...up, etc.) of the revenue cycle while also providing support when IT related or systematic changes are needed.… 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 ... physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you… more
- CDM Smith (San Antonio, 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