- AIG (Dallas, TX)
- …best meets clients' needs. + Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit , credit and legal to develop ... and maintain a profitable portfolio of primary accounts business. + Ability to collaborate with other product lines to provide full product support to the client. + Ability to interact with all levels of the organization. + Drive a culture that promotes… more
- AIG (Dallas, TX)
- …best meets clients' needs. + Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit , credit and legal to develop ... and maintain a profitable portfolio of primary accounts business. + Adhering to underwriting rules and guidelines. + Ability to collaborate with other product lines to provide full product support to the client. + Strong relationships with brokers to ensure a… more
- The Hartford (San Antonio, TX)
- …be determined.* Facilitate gathering and exchange of information with Claims regardingobserved and identified billing issues.* Identify opportunities warranting ... further investigation through discussionwith Claims and law firms, properly escalating observations internally aswell...review of the bill by the field handlerthrough final audit at the appeal level.* Support Claim reorganization and… more
- Highmark Health (Austin, TX)
- …responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The incumbent will also ... services and charges; will monitor internal referrals from sources such as claims , customer service, Medicare C&D Compliance, and Fraud Hotlines; will alert… more
- Sedgwick (Austin, TX)
- …United States. **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, ... FUNCTIONS and RESPONSIBILITIES** + Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations.… more
- The Hunton Group (Houston, TX)
- …File M/S's, freight bills of lading, equipment packing slips for inventory reconciliation and audit purposes. + File freight claims for damaged goods. + Manage ... receipt, inspecting, and stocking products. + Determine inventory levels; identify and dispose of excess and obsolete inventory and maintaining system inventory accuracy. + Other duties may be assigned. Skills Required: + Must have and maintain a valid… more
- Sedgwick (Fort Worth, TX)
- …work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all ... claims to ensure information substantiates disability. + Provides clear...status, progress and work status. + Achieves appropriate quality audit scores on a consistent basis. + Acts as… more
- Sedgwick (Houston, TX)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care; transfers payment allocations; and runs manual pre-pay… more
- Highmark Health (Austin, TX)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- Wolters Kluwer (Houston, TX)
- …platforms. In addition, during heavy periods of incoming invoice volume, conduct the initial audit and/or quality assurance invoice review audit up to 15% of the ... prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal...and to exercise discretion and sound judgment when making audit and adjustment decisions. + Understanding of legal terminology… more