• Medical Director - OP Claims Mgmt

    Humana (Austin, TX)
    …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group practice ... management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG(R) or InterQual + Internal Medicine,… more
    Humana (11/24/25)
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  • Onsite Billing Specialist I- Clinic

    Community Health Systems (Corsicana, TX)
    …Summary** The Billing Specialist I is responsible for performing insurance claim processing, billing, and follow-up to ensure timely and accurate reimbursement. ... contact for insurance companies and other payers, researching and resolving claim issues while maintaining compliance with billing regulations and organizational… more
    Community Health Systems (01/07/26)
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  • Disability Representative

    Sedgwick (Irving, TX)
    …payment information and claims status by phone, written correspondence and/or claims system . + Communicates with the claimants' providers to set expectations ... aspects of claims process by phone, written correspondence and/or claims system . + Coordinates investigative efforts ensuring appropriateness; provides… more
    Sedgwick (11/25/25)
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  • SIU Investigator

    Allied Universal (Austin, TX)
    Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
    Allied Universal (12/27/25)
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  • Sr. Patient Account Specialist - RCO HB Follow Up

    UTMB Health (Galveston, TX)
    …rejections from billing system daily to bill submit hospital and/or physicians claims + Performs online corrections to edited claims according to procedures ... with Epic Resolute PB/HB for managing high-balance A/R and claim edits. + Skilled in Epic Claim ...be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional… more
    UTMB Health (01/15/26)
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  • Disability Representative Sr.

    Sedgwick (Irving, TX)
    … claim status through phone calls, written correspondence, and system updates.** **Engages with healthcare providers to establish expectations for return-to-work ... consistent and transparent communication with claimants and clients throughout the claims process via phone, written updates, and system documentation.**… more
    Sedgwick (12/30/25)
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  • Disability Representative Sr

    Sedgwick (Irving, TX)
    …payment information and claims status by phone, written correspondence and/or claims system . + Communicates with the claimants' providers to set expectations ... aspects of claims process by phone, written correspondence and/or claims system . + Coordinates investigative efforts ensuring appropriateness; provides… more
    Sedgwick (11/18/25)
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  • Senior Coding Specialist

    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...system - one of the nation's leading health systems - the Primary Care Group offers efficient access… more
    Houston Methodist (01/13/26)
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  • Disability Clinical Specialist

    Sedgwick (Austin, TX)
    …of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for ... Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client… more
    Sedgwick (10/24/25)
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  • Safety Specialist

    Johnson Thermal Systems (Abilene, TX)
    …practices using leading and trailing indicators. + Facilitates the workers' compensation claims process including initial entering of claim ; assisting in the ... adjusters, and investigators; and processing documents pertaining to the incident and claim . + Facilitate onboarding of new employees and various classroom and… more
    Johnson Thermal Systems (12/17/25)
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