• Specialist , Appeals & Grievances - Remote…

    Molina Healthcare (Dallas, TX)
    …and prepares written response to incoming provider reconsideration requests related to claims payment, requests for claim adjustments, and/or requests from ... JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to… more
    Molina Healthcare (11/23/25)
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  • Revenue Cycle Management Specialist

    KPH Healthcare Services, Inc. (Longview, TX)
    **Overview** The Revenue Cycle Management Specialist - Collections responsibility is to ensure timely collection of outstanding balances. **Responsibilities** + ... Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible parties via phone, email, and written… more
    KPH Healthcare Services, Inc. (11/15/25)
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  • (Remote) EDI Support Specialist - Casualty

    Sedgwick (Austin, TX)
    …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including… more
    Sedgwick (11/06/25)
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  • ADA Accommodation Specialist

    Sedgwick (San Antonio, TX)
    …Work(R) Fortune Best Workplaces in Financial Services & Insurance ADA Accommodation Specialist **PRIMARY PURPOSE** : To enhance the ADA process for claimants ... requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation requests; and to approve and/or negotiate… more
    Sedgwick (11/21/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Austin, TX)
    …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
    Molina Healthcare (11/14/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Fort Worth, TX)
    …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
    Molina Healthcare (11/07/25)
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  • FEMA - Program Delivery Specialist

    CDM Smith (El Paso, TX)
    …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
    CDM Smith (10/18/25)
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  • Senior Business Control Specialist

    PennyMac (Carrollton, TX)
    …through the complete mortgage journey. A Typical Day The Senior Business Control Specialist assists in the development of a mortgage centric compliance program that ... assists in creating an effective control environment. The Senior Business Control Specialist will : + Utilizing investor guidelines, research repurchase claims more
    PennyMac (10/15/25)
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  • Hospital Billing and Claims Application…

    Deloitte (Fort Worth, TX)
    …environment. As an experienced Epic Resolute Hospital Billing Analyst Project Delivery Specialist , you will have the ability to share new ideas and collaborate ... you'll do/Responsibilities + Support Epic enterprise implementation for a large academic medical center and health system in the Southeast region. + Conduct Epic… more
    Deloitte (10/31/25)
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  • Oncology Accounts Receivable Specialist

    Urology Clinics of North Texas (Mesquite, TX)
    …billing, office-administered medications, infusion cycles, and chemotherapy regimen cycles. The specialist will ensure timely follow-up on claims , accurate ... Oncology Accounts Receivable Specialist Job Details Job Location 1650 Republic Pkwy...office-administered medications and infusion services. + Strong knowledge of medical terminology, insurance plans, claims , and billing… more
    Urology Clinics of North Texas (11/01/25)
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