- Sedgwick (Dallas, TX)
- …audit requirements, standards, and service contract requirements. + Maintains contact with operations teams on claims and promotes a professional relationship; ... RESPONSIBILITIES** + Provides support, feedback, and guidance concerning daily operations and audit activity to the Quality team. +... as suggested by the audit results. + Ensures claims files are coded correctly, and adequate documentation is… more
- Kelsey-Seybold Clinic (TX)
- …applications to respond to administrative issues related to health plan operations including claims resolution, premium billing, medical benefit interpretation, ... Skills** Required: Strong knowledge of HMOPOS and TPA Plan Design and Claims Processing Member Service Representatives must build and maintain productive Preferred:… more
- Kemper (Mcallen, TX)
- …processing and performance metrics. **POSITION RESPONSIBILITIES:** + Manages the day-to-day operations for assigned claims staff by establishing schedules and ... priorities, coaches employees in reviewing, analyzing, investigating, negotiating and settling claims in compliance with Kemper Claims Standards. + Responsible… more
- Kemper (San Antonio, TX)
- …preferred. + Bilingual English/Spanish is a plus. + Knowledge of insurance operations : underwriting, claims , marketing, and product. + Required to possess ... effective communication skills + Must be flexible in nature and a highly motivated self-starter. + Ability to manipulate, segment and interpret report data through spreadsheets. + Highly skilled and effective at time management. + Should possess and… more
- Centene Corporation (Austin, TX)
- …but not limited to reimbursement strategy, contracting strategy, unit cost management, claims configuration and network operations . + Oversee network development ... staff and external consultants in the development of provider networks across expansion markets + Lead health plans in periodic analysis of their provider networks from a cost, coverage, and growth perspective + Provide leadership in evaluating opportunities… more
- Robert Half Office Team (Pasadena, TX)
- …offerings. * Oversee employee enrollment processes, status updates, and resolution of claims to ensure smooth operations . * Maintain and update benefits-related ... resources across internal platforms to keep information accessible and accurate. * Manage 401(k) retirement plans, including enrollments, loans, withdrawals, and compliance reporting. * Provide guidance and support to employees regarding benefit options and… more
- Axis (TX)
- …Development: Partner with the Excess Casualty Leadership and various business partners ( Claims , Actuarial, Distribution, and Operations ) and to support and ... influence the strategic direction of the Construction, Manufacturing, Transportation, and other areas. Provide insights on market trends and emerging risks to help refine underwriting practices. * Strategic Responsibilities: Contribute to the development and… more
- The Hartford (San Antonio, TX)
- …include State Product Management, Agency and Direct Distribution Channel and Marketing, Claims , Legal and Compliance, Operations including Billing Ops, IT, DS ... and Strategy. Qualifications: + Bachelor's degree preferred + 3+ years of prior relevant work experience, 5+ years insurance experience preferred + Demonstrated usage of Microsoft Office products, including Excel and PowerPoint. + Demonstrated critical… more
- Audi (Austin, TX)
- …document based on product improvements and learnings; ensure that ADMT’s product and operations fulfill the claims included in the VSSA. · Review the ... and business development, software development and end-2-end integration, fleet operations to next-generation self-driving systems. Being the driver in Volkswagen… 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 ... able to work independently and with others to review claims tied to different overpayment projects in the Overpayment...in the Overpayment Tracking System, revalidate overpayment files, send claims to rework and verify accuracy when needed. The… more