- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** The ** Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ... ), FI ( _fully insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing… more
- Zurich NA (Austin, TX)
- … - Complex Construction 126105 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our Complex Liability Claims ... outcomes. + Ensure regular communication with clients, brokers, business units, and senior claims management. + Proactively manage and resolve high-severity… more
- The Hartford (San Antonio, TX)
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Specialist , you will be responsible for… more
- Ascension Health (Austin, TX)
- …by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. + ... that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes....of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision… more
- Allied Solutions (Plano, TX)
- Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This ... will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- UTMB Health (Galveston, TX)
- Senior Risk Management Specialist (Partially Remote) - Department of Legal Affairs **Galveston, Texas, United States** **New** Legal & Compliance UTMB Health ... programs, clinical issues, device and equipment, incident management, and claims /lawsuits. **Job Duties:** + Administrative liaison for Risk Management issues.… more
- CVS Health (Austin, TX)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Austin, TX)
- …both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard practices to ... and timely support. + Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements as well as daily operations… more
- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary** The ** Senior Accounts Receivable Specialist ** prepares accounting and financial records and ... monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+… more
- Centene Corporation (Austin, TX)
- …a Monday - Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and ... calls with members and provider offices to provide resolution to claims (ie: additional information requests and medication determination updates) + Thoroughly… more
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