• Claims Processing Specialist

    Kelsey-Seybold Clinic (Pearland, TX)
    …meet work standards and performance measures for this position **Job Title: Claims Processing Specialist ** **Location: Pearland Administrative Office** ... laws and regulations governing Medicare billing practices, medical billing systems, and claims processing . Preferred: IDX/EPIC, PC skills, and understanding of… more
    Kelsey-Seybold Clinic (05/02/25)
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  • Senior Claims Benefit Specialist…

    CVS Health (Austin, TX)
    …+ Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. + Applies medical necessity guidelines, ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
    CVS Health (07/09/25)
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  • Claims Specialist Sr - Commercial…

    Sedgwick (Austin, TX)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
    Sedgwick (07/10/25)
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  • Senior Claims Specialist…

    Sedgwick (Austin, TX)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Claims Specialist , Professional Liability (A&E, D&O) **ESSENTIAL FUNCTIONS and ... RESPONSIBILITIES** + Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on… more
    Sedgwick (06/29/25)
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  • Sr. Claims Specialist , Medical…

    Sedgwick (Austin, TX)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , Medical Malpractice (LTC) **PRIMARY PURPOSE** : To analyze ... complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
    Sedgwick (06/21/25)
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  • Claims Adjudication Specialist

    Mass Markets (Killeen, TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong critical thinking skills,… more
    Mass Markets (05/30/25)
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  • Claims Investigator

    Allied Solutions (Plano, TX)
    …Loss, GAP, CPI and others as assigned. This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...insurance/recovery claim experience as a Claim Processor or Claim Specialist with a minimum of 9 months to 2… more
    Allied Solutions (07/13/25)
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  • Patient Account Specialist - Revenue Cycle…

    UTMB Health (Galveston, TX)
    … Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital ... Patient Account Specialist - Revenue Cycle HB Billing & Denials **Galveston,... claims . Identifies billing issues affecting hospital and/or physicians claims… more
    UTMB Health (07/08/25)
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  • Specialist III - Medical Billing…

    Sam Houston State University (Huntsville, TX)
    …can be translated by payers and other medical professionals. Ensures timely and accurate processing of medical claims , follow-up of unpaid or underpaid claims ... Three years of experience in medical billing, charge entry, coding, and claims follow-up, ideally within a multi-specialty group that focuses on family medicine,… more
    Sam Houston State University (06/25/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (San Antonio, TX)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
    Molina Healthcare (07/10/25)
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