• General Liability Technical Specialist

    Travelers Insurance Company (Richardson, TX)
    …and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle ... support flexibility. **What Will You Do?** + Directly handles assigned severe claims . + Provides quality customer service and ensures file quality and timely… more
    Travelers Insurance Company (08/22/25)
    - Related Jobs
  • General Liability Major Case Specialist

    Travelers Insurance Company (Houston, TX)
    …evaluating, reserving, negotiating and resolving assigned serious and complex General Liability claims . Provides quality claim handling throughout the claim life ... and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training… more
    Travelers Insurance Company (08/13/25)
    - Related Jobs
  • Claim Benefit Specialist

    CVS Health (Austin, TX)
    …Process claims accurately to enhance customer satisfaction and retention + Process claims within quality and production standards + Assist team members in ... heart, each and every day. **Claim Benefit Specialist** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have… more
    CVS Health (08/20/25)
    - Related Jobs
  • DRG Coding Auditor

    Elevance Health (Houston, TX)
    …CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all ... of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of the following… more
    Elevance Health (08/13/25)
    - Related Jobs
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Grand Prairie, TX)
    …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims more
    Elevance Health (08/09/25)
    - Related Jobs
  • Director, Operational Oversight (Medicare/Duals)…

    Molina Healthcare (Fort Worth, TX)
    …and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer ... grievances, and member communications. * Exposure to downstream domains: Enrollment, Claims , Pharmacy/PDE, Network, Stars quality metrics. * Proven record… more
    Molina Healthcare (07/13/25)
    - Related Jobs
  • Claims Examiner

    NTT DATA North America (Plano, TX)
    …we know that with the right people on board, anything is possible. The quality , integrity, and commitment of our employees have been key factors in our company's ... as part of an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team for a remote position. **Role Responsibilities**… more
    NTT DATA North America (08/29/25)
    - Related Jobs
  • Claims Processor/HNAS

    Highmark Health (Austin, TX)
    …and/or performing quality control review and final adjudication of paper/electronic claims . Determines whether to return, deny or pay claims following ... claims and inquiries to determine corrective action including adjusting claims as necessary and takes the corrective action steps using enrollment, benefit… more
    Highmark Health (08/29/25)
    - Related Jobs
  • Lead Adjudicator, Provider Claims

    Molina Healthcare (Austin, TX)
    …Description** **Job Summary** Responsible for work load assignment to the provider Claims adjudicators and senior provider claims adjudicators. Train and coach ... new employees. Provide clear and concise results on the provider claims model across all states. Monitors and controls workflow. Provides support to leadership… more
    Molina Healthcare (08/28/25)
    - Related Jobs
  • Commercial Auto Claims Representative…

    The Hartford (San Antonio, TX)
    APD Claims Representative - CH10IN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. ... put the customer at the center of everything we do. Our Claims Representatives investigates and maintains workers' compensation, property/casualty claims .… more
    The Hartford (08/26/25)
    - Related Jobs