- Travelers Insurance Company (Fort Worth, TX)
- …this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim ... resolution for personal or business claims of moderate severity and complexity. Handles ...business other than property (ie auto, workers compensation, premium audit , underwriting) may be required. Provides quality claim handling… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …ready, oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity. ... sites, and vendors (including contract research organizations) and ensure that audit results are communicated, and appropriate corrective actions are implemented and… more
- Toyota (Plano, TX)
- …Toyota's Corporate Insurance & Risk Management Department within the Compliance & Audit seeks a passionate and highly motivated **Insurance Risk Analyst** . ... North American region, processing insurance requests, creating/updating analytical reports, claims management, providing risk management support, and consultation to… more
- Baylor Scott & White Health (Temple, TX)
- …validating, and ensuring the accuracy of EDI transactions related to healthcare claims . This role involves working closely with developers, business analysts, and ... EDI teams to ensure that claims data meets internal standards and regulatory compliance (HIPAA,...business rules. + Create detailed documentation, QA reports, and audit logs. + Participate in release management and deployment… more
- Molina Healthcare (San Antonio, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... + Manages Scorable Action Items (SAIs) related to pre-pay editing, post-pay audit , and overpayment recovery initiatives to ensure Health Plan SAI targets are… more
- Sedgwick (Dallas, 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
- Academy Sports + Outdoors (Katy, TX)
- …or more areas such as: I-9/E-Verify, background checks, unemployment claims , talent acquisition, leave administration, compensation, benefits, learning and ... as subject matter expert for Academy's background check, I-9/E-Verify, and Unemployment Claims processes in alignment and under the general guidance of HR Operations… more
- Highmark Health (Austin, TX)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... training and mentor programs, and assists to provide interview/hiring and audit support when needed. **ESSENTIAL RESPONSIBILITIES** + Supervises the daily operations… 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
- Sedgwick (Fort Worth, TX)
- …+ Retrieve hotel folios (receipts) from properties for completed and partial stays + Audit hotel folios and related claims for billing accuracy, compliance, and ... resolve issues and answer questions. + Accurately and efficiently enters new housing claims into the system. + Monitors inbound email for claim questions, approvals,… more