- Evolent (Austin, TX)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- Kemper (Mcallen, TX)
- …parts were utilized within Industry Standards. + Examine third-party Total Loss claims through photos, estimates, total loss valuations to ensure valuations are ... the facts of the claim and within Industry Standards. + Ensure adherence to claims procedures and guidelines prescribed by the company to produce a high-quality work… more
- Centene Corporation (Austin, TX)
- …in the Continental United States. **Position Purpose:** Direct and oversee claims audit operations and medical code editing scenarios. Oversee payment integrity ... years of Managed Care or CMS related experience, including compliance, claims , payment integrity, or special investigation experience required. + Previous management… more
- Kemper (Dallas, TX)
- …on assigned cases Aggressively pursues files referred to Staff Counsel by the Claims Department. + Creates and maintains a documented strategy for case handling in ... of pleadings, briefs and memorandums. + Prepares and submits timely status reports to claims handlers on all significant activities as they occur, but at no greater… more
- New Jersey Resources (Houston, TX)
- …and subsequent response analysis reviews. * Assist in managing Workers' Compensation Claims , Return to Work programs, accident reports, claims and lead ... sex, sexual orientation, age, gender identity and/or expression, national origin, disability , veteran, or other protected status. Job Details Job Function Director… more
- Simplot (College Station, TX)
- …the region. Work with Crop Advisors and sales leadership to evaluate crop claims . Provide feedback and suggestions to the Digital Platform Manager for the digital ... regional research results including product performance and placement. + Evaluate crop claims for Crop Advisors and sales leadership. + Provide feedback and… more
- Baylor Scott & White Health (Irving, TX)
- …of patient registration procedures and documentation. + Knowledge of medical insurance claims procedures and documentation. Needs to have thorough knowledge of the ... preparing and maintaining patient records. + Able to examine unpaid third-party claims and delinquent accounts to resolve appropriate follow-up actions to ensure… more
- Texas A&M University System (College Station, TX)
- …maximum price proposals. Additionally, provides review and assistance with contract claims , potential errors and omissions and construction design defect matters, ... approves construction agenda items for the Board of Regents, assists with potential claims against project performance and payment bonds, and works with the Office… more
- Kemper (San Antonio, TX)
- …and state requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. + Performs other duties ... sales/marketing management experience + Extensive knowledge of insurance operations: claims , coverages, products and underwriting is preferable to effectively… more
- Sedgwick (Austin, TX)
- …but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more