• Complex Claims Advisor | Commercial GL…

    Sedgwick (Austin, TX)
    …Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote Are you looking for an opportunity to join a global industry leader where you ... needs. **ARE YOU AN IDEAL CANDIDATE?** Are you an experienced attorney or examiner with a strong background in insurance coverage analysis? We're seeking an… more
    Sedgwick (09/25/25)
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  • Specialist, Claims Recovery ( Remote…

    Molina Healthcare (TX)
    …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication, Claims Examiner II, or other relevant work ... **Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines,… more
    Molina Healthcare (10/30/25)
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  • Property Field Claims Manager (Texas…

    American Family Insurance - Corporate (Houston, TX)
    …engagement activities such as team meetings, trainings, and culture events. \#LI- Remote Position Compensation Range: $86,000.00 - $142,000.00 Pay Rate Type: Salary ... effective solutions for dealing with problems, situations and conflicts. *Comply with Unfair Claims Practices Acts and ensures handling of claims in good faith.… more
    American Family Insurance - Corporate (10/30/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (Houston, TX)
    …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
    Molina Healthcare (10/22/25)
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  • Telephonic Case Manager

    Sedgwick (Austin, TX)
    …and support systems. + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... on the health and lives of others, and a remote work environment. + Enjoy flexibility and autonomy in...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
    Sedgwick (10/22/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (San Antonio, TX)
    …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... providers when overpayments are identified. + Works may be remote , in office, and on-site travel within the state...Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you… more
    Molina Healthcare (09/22/25)
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