• Claims Adjudication Specialist

    Mass Markets (Killeen, TX)
    …1-3 years of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a ... expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong… more
    Mass Markets (11/26/25)
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  • Senior Analyst, Claims Research

    Molina Healthcare (Austin, TX)
    …solutions. + Interprets regulatory and contractual requirements to ensure compliance in claims adjudication and remediation processes. + Develops, tracks, and / ... and project management. + Advanced knowledge of medical billing codes and claims adjudication processes. + Strong analytical, organizational, and problem-solving… more
    Molina Healthcare (12/05/25)
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  • Claims Team Lead - General Liability…

    Sedgwick (Austin, TX)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/02/25)
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  • Assistant Claims Team Lead - Workers…

    Sedgwick (Austin, TX)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (11/21/25)
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  • Claims Team Lead | Auto Property Damage…

    Sedgwick (Austin, TX)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/20/25)
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  • Claims Team Lead - Liability | Auto…

    Sedgwick (Fort Worth, TX)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/15/25)
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  • Liability Claims Team Lead - Commercial…

    Sedgwick (San Antonio, TX)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/08/25)
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  • Claims Examiner

    NTT America, Inc. (Plano, TX)
    …and work on weekend's basis business requirement. **Roles and Responsibilities:** + Process Adjudication claims and resolve for payment and Denials + Knowledge ... pre-established guidelines **Requirements:** + 1-3 years of experience in processing claims adjudication and adjustment process + Experience of Facets is an… more
    NTT America, Inc. (12/07/25)
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  • Adjudicator, Provider Claims

    Molina Healthcare (Dallas, TX)
    JOB DESCRIPTION **Job Summary** Provides support for provider claims adjudication activities including responding to providers to address claim issues, and ... researching, investigating and ensuring appropriate resolution of claims . **Essential Job Duties** * Provides support for resolution of provider claims issues,… more
    Molina Healthcare (12/04/25)
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  • Lead Director, Software Engineering - Commercial…

    CVS Health (Irving, TX)
    …and modernization of legacy systems-primarily IBM Mainframe platforms-used for commercial claims routing, adjudication , and operational reporting. This role ... ** **Key Responsibilities** + Own engineering strategy and execution for commercial claims systems, including routing, adjudication , and operational reporting. +… more
    CVS Health (12/06/25)
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