- Molina Healthcare (San Antonio, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge,… more
- TEKsystems (West Lake Hills, TX)
- …clinical experts, data scientists, and legal consultants to shape the future of medical claims review and healthcare resource optimization. Job ... * Develop economic models to assess the impact of medical interventions and policy changes. * Conduct cost-benefit and...* Collaborate on the design of predictive tools for claims review and risk stratification. * Prepare… more
- Providence (TX)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... Program:** + Communicate with patients, claimants, caregivers, providers, leadership + Review and analyze medical records, interview witnesses, assist with… more
- Cognizant (Austin, TX)
- …of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent ... to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication...with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or… more
- NTT DATA North America (Dallas, TX)
- …the timelines to complete compliance training of NTT Data/Client + Work independently to research, review and act on the claims + Prioritize work and adjudicate ... NTT DATA is currently seeking 20 Remote Claims Examiners to join our team. (Amisys or...claims as per turnaround time/SLAs + Ensure claims are adjudicated as per clients defined workflows, guidelines… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Remote Medical Claims Examiner to join our team in Plano, Texas (US-TX), ... complete compliance training of NTT Data/Client + Work independently to research, review and act on the claims + Prioritize work and adjudicate claims as per… more
- NTT DATA North America (Plano, TX)
- …the timelines to complete compliance training of NTT Data/Client + Work independently to research, review and act on the claims + Prioritize work and adjudicate ... here. NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client...claims as per turnaround time/SLAs + Ensure claims are adjudicated as per clients defined workflows, guidelines… more
- Ryder System (Austin, TX)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Senior Claims Representative handles complex and mid-to-high exposure bodily injury...all relevant laws and regulations as well as related medical and legal terminology + Requires strong claim technical… more
- USAA (San Antonio, TX)
- …what truly makes us special and impactful. **The Opportunity** As a dedicated Manager, Claims Operations, you will lead and be accountable for property, and other ... claims operations member service employees who are responsible for...for this position. **What you'll do:** + Inspect and review quality of claim files and provide feedback to… more
- Sedgwick (Irving, TX)
- …properly documented and claims coding is correct.** May process low-level lifetime medical and/or defined period medical claims which include state and ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Liability - Property Damage - Irving, TX - Hybrid **ARE YOU… more