- Sedgwick (Dallas, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance SAP FICO Systems Analyst **PRIMARY PURPOSE** : To design and maintain robust, ... + Ensures software scalability and data integrity throughout all claims -related applications. + Ensures software compatibility and alignment with overall… more
- Southland Industries (Carrollton, TX)
- …of status changes. + Assume point-of-contact role with regard to physicians, clinics, insurance provider, and employees with open w/c claims + Request MVRs ... to Brandt's/Southland safety department, with heavy emphasis on workers compensation claims management. **What you'll do:** + Provide administrative support to group… more
- USAA (San Antonio, TX)
- …tools and resources to evaluate SIU referrals and identify potential fraud within claims or policies. Monitor and identify fraud trends through ongoing analysis and ... teams. **What you'll do:** + Reviews data such as claims or policy files, medical bills, vendor billing, damage...to proactively identify suspicious patterns and trends of organized insurance fraud. + Leverage referral data from manual and… more
- EMCOR Group (Manchaca, TX)
- …monthly overhead expenditures to justify and/or correct budget variances. + Prepare monthly insurance loss runs and status of existing claims to determine ... as needed and ensure that changes in labor rates, insurance rates and tax rates are communicated timely and...Manager for inclusion of terms and discounts. + Coordinate claims issues and legal activity with EMCOR Construction Services… more
- TEKsystems (Houston, TX)
- … follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, appeals letter, denials, insurance follow ups Top ... just picking up the phone to communicate and solve problems - determine why claims are denied - determine where to send appeals - determine whether a claim… more
- Hensel Phelps (El Paso, TX)
- …to aid in the management of the schedule and implement controls to avoid claims . + Analyze delivery impacts, time extensions, claims , etc. using schedule ... fragments. + Interact with scheduling consultant in schedule reviews, claims analysis, etc. Perform monthly cash flow projections and analysis. + Perform workforce… more
- Humana (Austin, TX)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- Sedgwick (Austin, TX)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance (Remote) Director National Technical Compliance - Casualty **PRIMARY PURPOSE** : To ... requirements + Ability to research technical issues + In-depth technical knowledge of claims management, managed care or call center operations + Excellent oral and… more
- Sedgwick (Austin, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues… more
- Sedgwick (Austin, TX)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… more