- Sedgwick (Austin, TX)
- …accredited college or university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner . Familiar with CPT, DRG and resources ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do… more
- Sedgwick (Houston, TX)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (Austin, TX)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (San Antonio, TX)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (Fort Worth, TX)
- …with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and ... Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner . + Monitors third party claims ; maintains periodical… more
- Sedgwick (Irving, TX)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles, reviews, and… more
- Molina Healthcare (Dallas, TX)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to… more
- Sedgwick (Fort Worth, TX)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense… more
- CDM Smith (Fort Worth, TX)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...such as CPA (Certified Public Accountant), CFE (Certified Fraud Examiner ), or CFF (Certified in Financial Forensics). **EEO Statement:**… more
- Sedgwick (Fort Worth, TX)
- …processes and products + Documents activity in MCS; communicates MCS action with examiner via JURIS notes + Creates daily reports to manage workload and monitors ... GED required **Experience** One (1) year of general office experience required. Claims or medical records/billing industry experience preferred. Two (2) years of… more