- Sedgwick (Irving, TX)
- …OF THE ROLE:** To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting ... the claims process, and providing detailed claim notes on all...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Sedgwick (Dallas, TX)
- …Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help… more
- Sedgwick (Dallas, TX)
- …+ Ensures software scalability and data integrity throughout all claims -related applications. + Ensures software compatibility and alignment with overall ... + Assists in projecting software and hardware requirements for claims -related applications. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties… more
- Zurich NA (Houston, TX)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Molina Healthcare (TX)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Sedgwick (Austin, TX)
- …demands, wages and benefits, and availability. + Thoroughly reviews contested claims . + Assists as needed with submission of accommodation recommendations to ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Elevance Health (Houston, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. + Assists with… more
- TEKsystems (West Lake Hills, TX)
- …data scientists, and legal consultants to shape the future of medical claims review and healthcare resource optimization. Job Responsibilities: * Analyze healthcare ... * Collaborate on the design of predictive tools for claims review and risk stratification. * Prepare reports and...+ Experience in healthcare analytics, insurance economics, or medical claims analysis. + Proficiency in statistical software (eg, R,… more
- CVS Health (Austin, TX)
- …bound calls to clients and payers, while working with other teams to resolve claims issues. + Documenting claims details into necessary tools. + Presenting data ... and accurately. **Required Qualifications** + 1+ years of experience working with medical claims with the understanding of how benefit levels are applied. + 1+ years… more
- NTT America, Inc. (Houston, TX)
- …per the requirement and according to defined business rules of new claims processing platform. + Evaluation of Configuration Requirement and Formulation of ... + Support activities to update configuration within the core claims processing system, typically within the areas of Provider...have Over all 5+ years' experience in US healthcare Claims Payer. + 6 + year(s) experience in Configuring… more