• Claims Examiner Workers Comp…

    Sedgwick (Austin, TX)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Comp I Remote I SE, Central, NE regions **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
    Sedgwick (06/29/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (San Antonio, TX)
    …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery,… more
    Molina Healthcare (07/18/25)
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  • Commercial Casualty Claims Adjuster…

    GuideOne Insurance (Houston, TX)
    Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without ... and cause of loss on routine to more complicated claims , which includes but is not limited to policy...and AD&D, long-term disability and short-term disability insurance + Medical , dental and vision plans to meet your unique… more
    GuideOne Insurance (08/13/25)
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  • Remote - Claims Adjuster…

    Reynolds & Reynolds (Dallas, TX)
    Position Description * This is a full-time, remote position working from 9:45am to 6:15pm CSTAmerican Guardian Warranty Services, Inc. (AGWS), an affiliate of ... Reynolds and Reynolds, is seeking Claims Adjuster - Automotive for our growing team. In...are not limited to:-\tAnswering inbound calls-\tProvide information about claim processing and explain the different levels of contract coverage… more
    Reynolds & Reynolds (08/08/25)
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  • Medical Insurance Claims Specialist

    HCA Healthcare (Houston, TX)
    …Do you want to join an organization that invests in you as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare has ... make a difference. We are looking for a dedicated Medical Insurance Claims Specialist like you to...Follow up Representative** , you will be responsible for processing insurance accounts to address claim issues and thereby… more
    HCA Healthcare (08/15/25)
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  • Claims Case Manager I, Supplemental…

    Guardian Life (Austin, TX)
    …MS Word/Excel/PP + College degree preferred or equivalent work experience + Claim processing experience preferred or working knowledge of claims processes + ... As the ** Claims Case Manager I** , **Supplemental Insurance,** you...corresponding type of service codes and benefit amounts for processing + Assess file to determine if benefits are… more
    Guardian Life (08/15/25)
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  • Senior Analyst, Medical Economics…

    Molina Healthcare (Fort Worth, TX)
    …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
    Molina Healthcare (07/10/25)
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  • Care Navigator - Billing Certified & Coding…

    IQVIA (Houston, TX)
    …as co-pay cards or vouchers. The **Care Navigator** is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against ... an IQVIA full-time employee. **Job Responsibilities:** + Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate… more
    IQVIA (08/13/25)
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  • Remote Pharmacy Technician

    Actalent (Dallas, TX)
    …retail pharmacy setting. + Prior authorization experience. + Familiarity with third-party claims processing . + Certified Pharmacy Technician (PTCB or NHA). Work ... Job Title: Remote Pharmacy Technician Job Description: As a ...for specialty drugs to delegated vendors or clients for processing . + Contacting providers for additional information to facilitate… more
    Actalent (08/02/25)
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  • Provider Data Management Processor - Remote

    NTT DATA North America (Dallas, TX)
    …experience) Preferred Skills/Experience: + Experience in Provider Data Management, Provider Credentialing, Medical Claims + 3+ years of experience using a ... NTT DATA, Inc. is currently seeking a Remote - Provider Data Management Processors to join...+ 3+ years of experience in a Health care processing (Provider Data Management preferred, Claims or… more
    NTT DATA North America (08/14/25)
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