- USAA (San Antonio, TX)
- …and framework, responsible to adjust attorney-involved, moderately complex bodily injury claims , and UM claims to include confirming coverage, determining ... liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge… more
- Molina Healthcare (TX)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- CVS Health (Austin, TX)
- …**Position Summary** This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and validate claims ... candidate will be able to work independently and with others to review claims tied to different overpayment projects in the Overpayment Tracking System, revalidate… more
- Travelers Insurance Company (Richardson, TX)
- …Analysis (CFA) for adherence to quality standards and trend analysis. + Utilizes diary management system to ensure that all claims are handled timely. At ... and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Molina Healthcare (Fort Worth, TX)
- **Job Summary** This position is responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with ... forecast funding needs, and evaluate ROI on the covered benefits and its management + Oversees vendor performance, compliance, and satisfaction, with a focus on… more
- Molina Healthcare (TX)
- …execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as ... Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate payment levels, optimize resource utilization,… more
- 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 ...required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling… more
- Humana (Austin, TX)
- …our caring community and help us put health first The Encounter Data Management Professional will conduct research and analysis to execute accurate, timely, and ... completeness of DSNP encounter submissions. Encounter Data Management Professional will have comprehensive knowledge of processes, policies and procedures as well as… more
- Zurich NA (Dallas, TX)
- Management Liability Underwriter Public D&O 126415 Invest in your career with an industry you can bank on Insurance! We are currently looking for an experienced ... Management Liability Underwriter Public Company and work out of...and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Travelers Insurance Company (Houston, TX)
- …Analysis (CFA) for adherence to quality standards and trend analysis. + Utilize diary management system to ensure that all claims are handled timely. At required ... reserving, negotiating and resolving assigned serious and complex General Liability claims . Provides quality claim handling throughout the claim life cycle (customer… more