- Alight (TX)
- …daily operations to ensure KPIs and SLAs are met. Monitor activities to meet deadlines, review claims cases for quality, + Collaborating with the Quality team to ... Claims Specialists. + Using subject matter expertise to refine and enhance claims review processes for better customer experience. + Mentoring and track… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …**Education** Required: High School diploma or GED Preferred: Additional training as a medical office assistant, medical claims processor, or medical ... Must be familiar with laws and regulations governing Medicare billing practices, medical billing systems, and claims processing. Preferred: IDX/EPIC, PC skills,… more
- Texas Veterans Commission (Midland, TX)
- …assisting veterans and eligible persons with the Department of Veterans Affairs claims process. Work involves collaboration with external partners to include the ... rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises and… more
- Philadelphia Insurance Companies (Plano, TX)
- …will provide legal counsel and strategic guidance regarding commercial property and casualty insurance claims . Reporting to VP of Claims & Claims Counsel, ... management. The successful candidate will serve as a key resource for claims professionals, underwriters, and company leadership, ensuring claims are… more
- Sedgwick (Austin, TX)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Commercial Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low to mid-level ... auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- GuideOne Insurance (Houston, TX)
- As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume ... and cause of loss on routine to more complicated claims , which includes but is not limited to policy..., which includes but is not limited to policy review , interviewing all parties associated with the loss and… more
- Molina Healthcare (San Antonio, TX)
- …Claim Experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, ... 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, Anesthesia, high… more
- Cognizant (Austin, TX)
- …1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able ... claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate… more
- CRC Insurance Services, Inc. (Flower Mound, TX)
- …or Temporary:** Regular **Language Fluency:** English (Required) **Work Shift:** **Please review the following job description:** Process claims , which includes ... attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs...Specific activities may change from time to time. 1. Review policy to determine if loss is covered. If… more
- USAA (San Antonio, TX)
- …and implementation of multiple Data and Analytics sub-functions for Claims that may include: Information Strategy and Architecture, Information Management, ... and long-term strategy and vision of the assigned sub-functions for the CoSA Claims working with peers to set objectives across the different sub-functions that… more