• Operations Manager

    Mass Markets (TX)
    …ranging from electronics to dream vacations and sometimes even cars! + Health Benefits:Full-time employees are eligible for comprehensive medical, dental, and vision ... your future with retirement savings programs, where available. + Disability Insurance :Short-term disability coverage is available to help protect you during… more
    Mass Markets (06/12/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Grand Prairie, TX)
    …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 ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
    Elevance Health (07/17/25)
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  • Insurance Verification Representative…

    Surgery Care Affiliates (Mansfield, TX)
    …401k plan with company match, paid time off, life and disability insurance , and more. Click here (https://careers.sca. health /why-sca) to learn more about ... insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain...payer and associated financial class. + When the patient's insurance is Out of Network notify the manager more
    Surgery Care Affiliates (07/15/25)
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  • Revenue Cycle Analyst

    Catholic Health Initiatives (Houston, TX)
    …requirements. Reports are produced for Revenue Cycle functions such claims submission, insurance follow‐up, cash management, credits/refunds, charge/payment ... escalated issues through critical thinking and problem solving skills; notifies Manager /Director of ongoing issues and concerns. 3. Independently performs complex… more
    Catholic Health Initiatives (07/13/25)
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  • Casualty Litigation Adjuster

    Kemper (Dallas, TX)
    …and external training programs to advance knowledge in the area of insurance claims . + Work closely with the manager , claims leadership and defense ... to our stakeholders that delivers on our promises._ **Position Summary:** Our Claims Litigation Specialist will investigate, evaluate and handle to conclusion all… more
    Kemper (07/24/25)
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  • Clinical Fraud Investigator II

    Elevance Health (Houston, TX)
    …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...dealing with Healthcare Fraud Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
    Elevance Health (08/01/25)
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  • Clinical Provider Auditor II

    Elevance Health (Houston, TX)
    …development. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities… more
    Elevance Health (08/01/25)
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  • Credit & Collections Specialist Senior

    Elevance Health (Plano, TX)
    …activities related to past due health insurance premiums and/or past due health insurance claims . **How You Will Make an Impact** : + Follows ... past due insurance premiums and/or past due health insurance claims . + Researches...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (07/25/25)
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  • IRE Grievance & Appeals Mgr II

    Elevance Health (Houston, TX)
    ** Manager II Grievance/Appeals** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... unless an accommodation is granted as required by law._ The ** Manager II Grievance/Appeals** responsible for management oversight of grievances and appeals… more
    Elevance Health (07/15/25)
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  • Adverse Subrogation and Arbitration Specialist

    Kemper (Dallas, TX)
    …review property damage claims , and secure damage valuations. + Submit claims for manager approval when exceeding settlement authority. + Prepare concise ... Arbitration Specialist at Kemper plays a critical role in resolving claims and handling intercompany arbitration cases. This position involves reviewing subrogation… more
    Kemper (07/24/25)
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