- Elevance Health (Grand Prairie, TX)
- …Auditor II is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + ... Examines claims for compliance with relevant billing and processing guidelines...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Elevance Health (Grand Prairie, TX)
- …Auditor II** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + ... Examines claims for compliance with relevant billing and processing guidelines...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Sedgwick (Bedford, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Case Coordinators. We help auto customers through the manufacturing claims process. **_We offer benefits on day one:_** +...+ Escalate customer, dealer or 3rd party issues to manager as appropriate + Ensure quality of service on… more
- AUI Partners (TX)
- …growth. 2) Inspections: + Report Safety Inspection findings to the Project Manager and Superintendent and ensure recommended changes have been implemented. + Hand ... + Assist HR, Legal and Compliance on Worker Compensation claims and other claims involving the public,...controls in place on assigned projects to the Project Manager and Superintendent + During the Project, conduct overview… more
- Evolent (Austin, TX)
- …the manage and report risk , issues, and decisions with the lead / manager + Responsible to attend and if required, lead test team meetings for technical testing ... The IQA reports to a associate director or a manager . One or many IQAs may be engaged in...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Sedgwick (Farmers Branch, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... from some of the world's most reputable brands + An assigned mentor and manager who will guide you on your career journey + Career development and promotional… more
- EMCOR Group (Manchaca, TX)
- …with company vendors and suppliers and coordinate vendor negotiations with Purchasing Manager for inclusion of terms and discounts. + Coordinate claims ... budget variances. + Prepare monthly insurance loss runs and status of existing claims to determine adequate reserves are accrued and adjusted as needed. + Manage… more
- Sedgwick (Irving, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... deliverables for assigned projects, including serving in role of project manager as assigned; ensures all projects follow Sedgwick software development lifecycle… more
- Rexel USA (Dallas, TX)
- …disability plans + Maintain employee benefit files related to LOA and disability claims , electronic or hard copy + Process all Short and Long-Term Disability ... policies/laws to prevent overpayments + Work with the Benefits Manager to assist with the ADA accommodation processes +...state and other forms related to leave of absence claims , verification of employment, child support orders, and other… more
- Molina Healthcare (San Antonio, TX)
- …laws and regulations, which will protect the Business from liability and potential risk . Ensures that the Business understands and complies with applicable laws and ... provisions, and internal policies and procedures. * Supports the Operational Oversight Manager , Director, and team in the general development of the Operational… more