Patient Account Representative - Physician Claims GuidehousePatient Account Representative - Physician ClaimsLewisville, TXThe Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event.
Claims Examiner – Auto IconmaClaims Examiner – AutoIrving, TX$35–$40 / hourExperience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage’s, principles, and laws. Must have commercial auto litigation experience, preferably in commercial trucking handling high severity/high value (in excess of (USD)1 million) losses.
Claims Examiner Auto ICONMA, LLCClaims Examiner AutoIrving, TX$35–$40 / hourExperience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage’s, principles, and laws. Processes commercial auto bodily injury claims and ensures claim files are properly documented and coded correctly.
Claims Examiner Intermediate OneMain (Formerly Springleaf & OneMain Financials).Claims Examiner IntermediateFort Worth, TXEnter data into appropriate processing systems, including correspondence with internal and external customers. 2+ year of general work experience, 6 months or more claims experience preferred.
Claims Finance Manager CareingtonClaims Finance ManagerFrisco, TexasThe Claims Finance Manager partners with Accounting & Finance, Claims, Configuration, Revenue Operations, Product, and Executive Leadership to evaluate the financial impact of claims decisions, identify opportunities to reduce payment leakage, improve adjudication accuracy, and support strategic business objectives. The Claims Finance Manager serves as the critical link between Claims Operations and Corporate Finance, ensuring financial accountability, payment accuracy, and operational efficiency throughout the claims adjudication lifecycle.
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorDallas, TX$25–$32 / hourPart timeNotary license strongly (preferred).Bilingual ability and/or degree in Criminal Justice or related field (preferred).Willingness to travel; flexible schedule (varied/irregular hours).Strong computer and internet skills. Accurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & ExperienceExperience handling complex SIU/Claims cases.
Sr Claims Clerk Crawford & CompanySr Claims ClerkDallas, TXRemoteFull timeLI-ET1 Matches proper file and/or claim number on unidentified correspondence by use of the various automated systems for mail delivered by USPS/ACS/Unmatched mail queue in ODM. Performs a variety of clerical duties such as answering telephones, taking messages, dispersing faxes, making payments, sort/preparing files, and data entry.
Accumulator Claims Coordinator NTT DATAAccumulator Claims CoordinatorPlano, TXRemote5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web-based applications. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity.
Physician ED Claims Reviewer VytwoPhysician ED Claims ReviewerDallas, TXRemoteFull timeRequired skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity. Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered.
Claims Examiner - Workers Compensation VytwoClaims Examiner - Workers CompensationDallas, TXRemoteFull timeExcellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations. To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Patient Account Representative - Medicare, Medicaid, Commercial Claims GuidehousePatient Account Representative - Medicare, Medicaid, Commercial ClaimsLewisville, TexasNote that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances.
NewClaims Examiner - Spinnaker Hippo Holdings IncClaims Examiner - SpinnakerDallas, TX$85,000–$120,000 / yearHippo treats its team members with the same level of dedication and care as we do our customers, which is why we're fortunate to provide all of our Hippos with: Healthy Hippos Benefits - Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. About The Role: The Claims Examiner - Partner Programs is responsible for the timely and accurate review and approval of claims exceeding the TPA's/Claim Administrator's authority, in accordance with company guidelines, regulatory requirements, and best claim practices.
NewManager, Engineering - Guidewire Claims Center Platform Liberty Mutual Holding Company IncManager, Engineering - Guidewire Claims Center PlatformPlano, TXKnowledge of technology concepts, strategies and methodologies typically acquired through a Bachelor s or Master s Degree in technical or business discipline and a minimum of five years' experience in a practice relevant domain including delivering software solutions in an agile environment. Job Summary: As an Engineering Manager for the Systems and Data Architecture teams within USRM Claims Technology, you will lead the engineering teams responsible for the Guidewire ClaimCenter platforms that power Liberty Mutual''s claims organization.
Claims Examiner - Auto Iconma LLCClaims Examiner - AutoIrving, TXExperience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage's, principles, and laws. Must have commercial auto litigation experience, preferably in commercial trucking handling high severity/high value (in excess of (USD)1 million) losses.
NewManager of Claims Processing GuideWell Mutual Holding CorpManager of Claims ProcessingIrving, TXThe Manager of Claims Processing is accountable for achieving business results through the application of effective leadership and management processes with a special emphasis and focus on reviewing procedures for new clients, Summary Plan Documents, and clarifying plan benefits. Primary contact for clients on day-to-day items and updates: Manage client relationships as primary contact for daily items, including weekly conference calls and monthly board meetings.
Complex Claims Specialist - AMAP Lockton IncComplex Claims Specialist - AMAPPlano, TXCoordinate implementation of claims savings solutions with Lockton Client Service Teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance. The objective of this role is to improve and reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client's employee health plan.
Senior Java Developer with Medicaid/ Medicare Claims Experience - 100% Remote The Dignify Solutions, LLCSenior Java Developer with Medicaid/ Medicare Claims Experience - 100% RemoteDallas, TXRemoteCandidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare. Candidate should have hands-on experience on claims processing and Adjudication processes.
Claims Specialist Aditi ConsultingClaims SpecialistPlano, TX$28.06 / hourConsent to Communication and Use of AI Technology: By submitting your application for this position and providing your email address(es) and/or phone number(s), you consent to receive text (SMS), email, and/or voice communication whether automated (including auto telephone dialing systems or automatic text messaging systems), pre-recorded, AI-assisted, or individually initiated from Aditi Consulting, our agents, representatives, or affiliates at the phone number and/or email address you have provided. You represent and warrant that the email address(es) and/or telephone number(s) you provided to us belong to you and that you are permitted to receive calls, text (SMS) messages, and/or emails at these contacts.
Commercial Claims Trainer Kemper Corp.Commercial Claims TrainerDallas, TXPOSITION RESPONSIBILITIES: Works with business leaders and subject matter experts to conduct needs analysis, develops learning objectives, content outline, presentation & training method, appropriate job aides and technology integration. Identifies issues or concerns with current training and takes appropriate action to reduce learning constraints and improve desired behaviors, outcomes and training results.
Claims Examiner - Auto Apidel TechnologiesClaims Examiner - AutoIrving, TXContractorMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Experience Five (5) years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverages, principles, and laws.