• Utilization Management Dental

    Humana (Austin, TX)
    …in compliance with review policies, procedures, and performance standards. o Review dental claims consistent with current ADA CDT terminology and current ... caring community and help us put health first** The Dental Director is responsible for providing clinical oversight to...states. This is accomplished by analysis and adjudication of claims , appeals, and potential quality of care issues. The… more
    Humana (08/23/25)
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  • Supervisor Dental Government Business…

    Highmark Health (Austin, TX)
    management skills + Knowledgeable in enrollment and billing, claims , and telephone customer service and written correspondence processes and applications ... **Company :** United Concordia Dental **Job Description :** **JOB SUMMARY** MUST BE...supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries… more
    Highmark Health (08/22/25)
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  • Associate Director, Commercial Data…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for strategically ... responsible for providing strategic insight and ensuring smooth day-to-day data lifecycle management processes and activities for data assets as follows: + Providing… more
    Otsuka America Pharmaceutical Inc. (08/13/25)
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  • Workers Compensation Program Manager

    Elior North America (Houston, TX)
    …Unit Management , Segment Leadership, and Human Resources to drive efficient claims management and reinforce workers' comp policies and procedures. + Track, ... with Elior North America's expectations and best practices in workers' compensation case management . + **Analyze workers' comp claims data** to identify trends… more
    Elior North America (08/14/25)
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  • Workforce Absence Team Lead

    Sedgwick (Irving, TX)
    … supervisory experience preferred. **Skills & Knowledge** + Thorough knowledge of claims management procedures and processes for disability + Excellent oral ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles, reviews, and analyzes management reports… more
    Sedgwick (08/20/25)
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  • Logistics Claim & Innovation Project Manager

    Samsung SDS America (Plano, TX)
    …operations. This dual-function role combines strong innovation project leadership and claims management expertise, focusing on warehouse optimization and ... Promote a culture of continuous improvement and innovation across all warehouse operations. Claims Management : + Manage and lead the team responsible for… more
    Samsung SDS America (07/30/25)
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  • Service Center Representative

    Sedgwick (San Antonio, TX)
    …information that meets both the internal and external customer's requirements accurately into the claims management system. + Assigns new claims to the ... + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. **Skills & Knowledge**...Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral and written… more
    Sedgwick (08/22/25)
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  • Disability Representative Sr.

    Sedgwick (Irving, TX)
    …on state regulations. **Experience** Three (3) years of benefits or disability case/ claims management experience or equivalent combination of education and ... Ave West Hills, CA 91304 **PRIMARY PURPOSE** : Provides disability case management and complex claim determinations based on medical documentation and the applicable… more
    Sedgwick (07/02/25)
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  • General & Product Liability Complex Claim Examiner…

    Sedgwick (Houston, TX)
    …as applicable to line of business preferred. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience ... - Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims more
    Sedgwick (08/08/25)
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  • Senior Encounter Data Management

    Humana (Austin, TX)
    …in determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep… more
    Humana (08/15/25)
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