- Walmart (Spring, TX)
- …customer queries and forward complex queries to the pharmacist. + Process insurance claims and manage payments. + Comply with all security measures and quality ... Participate in quality improvement initiatives to improve patient care and pharmacy operations . **Key Skills and Competencies:** + Knowledge of medication and dosage… more
- USAA (San Antonio, TX)
- …facilitate timely claims resolution. + Supports workload surges and/or Catastrophe Operations as needed. **What you have:** + High School Diploma or General ... coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable… more
- AIG (Dallas, TX)
- …of your technical expertise. Make your mark as a Forensic Analyst As a claims professional, you are respected for your deep accounting expertise. You balance the ... the quantification and the measurement of commercial business insurance claims . + Work with a team and supervisors and...an exciting time to join us - across our operations , we are thinking in new and innovative ways… more
- Sedgwick (Austin, TX)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... and Special Risks and Marine. As we expand our operations , we are seeking individuals who are passionate about...of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team… more
- CVS Health (Richardson, TX)
- …and/or Rebate knowledge beneficial. + Experience with Caremark business systems, claims adjudication, formulary, drug, and client systems with an emphasis on ... the RxClaim adjudication platform beneficial. + Medicare knowledge beneficial. + Ability to work independently and with people across functional area. + Ability to work in a hybrid team environment. + Strong reading comprehension skills. + Capability to… more
- Molina Healthcare (Austin, TX)
- …member inquiries, questions and concerns in all areas including enrollment, claims , benefit interpretation, and referrals/authorizations for medical care. + Provides ... exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal… more
- Public Consulting Group (Austin, TX)
- …Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Cardinal Health (Austin, TX)
- …their distribution channels, ensuring broader access to innovative therapies. + ** Claims Adjudication:** Oversee the claims adjudication process, ensuring timely ... and accurate processing of ATSP claims for CGT treatments. + **Compliance:** Ensure all contracting...highest standards of quality and compliance in all pharmacy operations , ensuring patient safety and product integrity. + **Patient-Centric… more
- USAA (Plano, TX)
- …The role is responsible for supporting third-party vendors involved in property claims . This includes being a great partner with all vendors that execute ... handle all aspects of managing a portfolio of contracts related to property claims and possess a strong understanding of third-party vendor management. **Key aspects… more
- Molina Healthcare (Austin, TX)
- …for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and ... experience and knowledge to research and resolve claim/encounter issues and pended claims , and updates system(s) as necessary. * Loads and maintains contracts,… more
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