- Reynolds & Reynolds (Dallas, TX)
- …Guardian Warranty Services, Inc. (AGWS), an affiliate of Reynolds and Reynolds, is seeking Claims Adjuster - Automotive for our growing team. In this role you will ... of contract coverage and terms -\tAccurately establish, review and authorize claims -\tEntering claim and contract information into the AGWS\u2019 systemA home office… more
- Zurich NA (Austin, TX)
- Inbound, Claims Call Center Representative 126049 Zurich is a leading multi-line insurer that serves its customers in global and local markets. Zurich's customers ... and self-motivated Customer Care Professionals to join our dedicated Claims Call Center team in (enter month and date)....Amazing PTO + 401K Match + Career mobility + Medical , Vision & Dental Basic Qualifications: + High School… more
- Molina Healthcare (Fort Worth, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... + Experience with Medicare, Medicaid and Marketplace is required. + Medical coding experience is highly preferred. **JOB QUALIFICATIONS** **Required Education**… more
- Guidehouse (Lewisville, TX)
- …TX office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up ... Would Be Nice To Have** **:** + 1+ year's medical provider experience working with UB04, appeals & denials....with UB04, appeals & denials. + Hospital or EOB claims emphasis + PC skills in a Windows environment.… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- USAA (San Antonio, TX)
- …Opportunity** As a dedicated **Strategic Account Relationship Manager Senior for Claims Optimization** , you will be responsible for developing, managing, growing, ... + Travel may be required. **What sets you apart:** + P&C Claims Operational experience, industry knowledge of contract requirements and experience with oversight… more
- CVS Health (Irving, TX)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure + Experience working with medical and/or pharmacy claims data + Experience in healthcare industry, including ... with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- CVS Health (Austin, TX)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Elevance Health (Grand Prairie, TX)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in… more
- Deloitte (Austin, TX)
- …and business terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims , including understanding financial impact of network ... emerging trends and cost drivers + Work directly with medical and PBM vendors to analyze the program offering...in rate negotiation, and analyzing financial terms for both medical and pharmacy + Prepare financial projections and rate… more