- Sedgwick (Austin, TX)
- …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 ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Amentum (Austin, TX)
- …appropriate insurance coverage and risk mitigation strategies. + Lead complex claims management, including litigation strategy and resolution in coordination with ... defense sectors.** + Deep knowledge of insurance products, risk financing, claims management, and enterprise risk practices. + Strong negotiation, communication, and… more
- Humana (Austin, TX)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access, PowerPoint) + Working knowledge of SQL + Familiarity with EDI X12 formats… more
- Molina Healthcare (San Antonio, TX)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Mass Markets (El Paso, TX)
- …and provide accurate solutions. + Use internal systems to manage accounts, process claims , and update records. + Follow scripts and procedures to ensure compliance ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- UIC Government Services and the Bowhead Family of Companies (San Antonio, TX)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Walgreens (Houston, TX)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Mass Markets (TX)
- …and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- BrightSpring Health Services (Lufkin, TX)
- …personnel costs, consultant services + Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas + Other duties as assigned Qualifications + BA/BS in Business, Health Care Administration, or Social… more
- Humana (Austin, TX)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more