- Kelsey-Seybold Clinic (Pearland, TX)
- …standards and performance measures for this position **Job Title: Claims Processing Specialist ** **Location: Pearland Administrative Office** **Department:** ... office assistant, medical claims processor, or medical claims follow up specialist . **Experience** Required: Minimum of 3 years billing experience, knowledge… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... _fully insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing… more
- The Hartford (San Antonio, TX)
- Specialist Claims - CH07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... theirs, too. Join our team as we help shape the future. The Specialist role of Workers Compensation, Major Case Unit will manage the investigation, litigation,… more
- Mass Markets (Killeen, TX)
- …in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong critical thinking skills, ... hear from you. This role involves handling inbound communications, evaluating warranty claims , and working closely with customers and service partners to ensure… more
- Baylor Scott & White Health (Dallas, TX)
- …**Job Summary** + Under the Safe Choice Claims Manager, the Safe Choice Claims Specialist II reviews, studies, and processes assigned claims within their ... prompt, efficient service while protecting the organization's assets. + The Claims Specialist II's main duty involves using discretion and independent judgment… more
- Ascension Health (Austin, TX)
- …by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. + ... agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + Composes all… more
- Cognizant (Austin, TX)
- …of claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...utilizing payer specific policies and procedures. Provide support to claims and client for issues related to claims… more
- Molina Healthcare (Houston, 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 ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Houston Methodist (Houston, TX)
- …is responsible for resolving all outstanding third-party primary and secondary insurance claims for professional services. This Specialist is required to perform ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...ESSENTIAL FUNCTIONS** + Collaborates with management to target complex claims and reduce aging of accounts by providing verbal… more
- Kemper (Dallas, TX)
- …attorney represented injury claims , complex injury claims , and litigated claims . The Litigation Specialist will have advanced claim handling skills and ... **Position Responsibilities:** + Successfully handle any complex coverage or liability claims investigation. + Evaluate complex injury claims and determine… more