NewClaims Examiner Senior \ Direct Placement60 - Contract TalentBurst, Inc.Claims Examiner Senior \ Direct Placement60 - ContractIrving, TX$23–$24 / hourThis role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
NewSafety & Training Supervisor Summit School ServicesSafety & Training SupervisorDeSoto, TXLicense or Certification: SBDI certification required; Commercial Driver’s License with Passenger and School Bus Endorsements required; Strong working knowledge of MS Office Software (Word, Excel, Outlook, PowerPoint, etc.) and transportation related software. Summit School Services companies share a strong commitment to provide the highest level of transportation safety, quality transportation, outstanding customer service and positive employee relations.
NewFRONT OFFICE & BILLING SUPERVISOR--CEDAR PARK OFFICE North Austin Pediatrics, P.A.FRONT OFFICE & BILLING SUPERVISOR--CEDAR PARK OFFICECEDAR PARK, TX$20–$24 / hourOversees front office duties delegation to ensure front office staff team is assigned to and maintains specific front office duties as working up specific provider appointments, front office flow, appointment scheduling policies followed, etc. Since 1997 we pride ourselves on offering a caring, personalized approach while being committed to the highest quality of care that makes the office a welcoming environment for everyone.
NewRisk Management Analyst RN Providence Health and ServicesRisk Management Analyst RNLubbock, TX$34–$52.79 / hourOur not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, hospice and home care, and even schools for nursing and radiography. Bachelor's Degree in Healthcare related from an accredited university; Nursing preferred or 3 years of experience in a clinical risk management/patient safety role with related professional certification, CPHRM or CPPS, or able to obtain within 1 year of employment.
Claims Supervisor CorVel Enterprise Claims, Inc.Claims SupervisorDallas, TX$71,696–$110,701 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Ancillary Claims Supervisor RoadVantageAncillary Claims SupervisorAustin, TexasEssential Job Functions: Oversee daily call center operations, including phone, email, and chat workflows, ensuring service levels and KPIs are consistently met (AHT, SLA, productivity, adherence). The Supervisor provides strong leadership, coaching, and operational oversight to a team of claims examiners, fostering a culture of accountability, consistency, and customer-focused service.
Claims Supervisor CorVel CorpClaims SupervisorDallas, TX$71,696–$110,701 / yearExcellent written and verbal communication skills • Ability to assist team members to develop knowledge and understanding of claims practice • Effective quantitative, analytical and interpretive skills • Strong leadership, management and motivational skills • Demonstrated, strong customer service skills • Ability to maintain composure under pressure and communicate diplomatically across various channels, including telephone, email, and written correspondence • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets • Strong interpersonal, time management and organizational skills • Ability to work both independently and within a team environment • Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation. • Bachelors degree or a combination of education and related experience • Demonstrated public speaking skills • Minimum of 5 years claims handling experience • Knowledge of WC required • Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel • Self-Insured Certificate preferred • State Certification as an experienced Examiner.
NewWorkers’ Compensation Claims Supervisor TEEMA GroupWorkers’ Compensation Claims SupervisorIrving, TX$85,000–$90,000The Workers’ Compensation Claims Supervisor is a key leadership role responsible for guiding and overseeing a high-performing claims team in a fast-paced, compliance-focused environment. The Supervisor ensures accurate claims handling, regulatory compliance, exceptional service delivery, and continuous professional development of staff, while serving as a trusted resource for clients and internal partners.
Claims Supervisor - TX Workers Compensation Claims GallagherClaims Supervisor - TX Workers Compensation ClaimsCarrollton, TexasRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. R equired Qualifications : • High School Diploma • Minimum of 10 years related claims experience • Appropriately licensed and/or certified in all states in which claims are being handled • Knowledge of all team member related functions D esired : • Bachelor's Degree .
Claims Supervisor University HealthClaims SupervisorSan Antonio, TXPOSITION SUMMARY/RESPONSIBILITIES Supervises, assists, and directs the activities of the assigned claims processing unit and the assigned staff. Three (3) or more years experience project coordination in a managed care environment is preferred.
Supervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminAustin, TXRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Manager, Claims Amtrust Financial Services IncManager, ClaimsDallas, TXThe WC Team Lead works with the Claim Adjusters to manage and ensure the Workers Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer and broker relations by identifying and meeting customer needs. Ensures that all AmTrust policies, procedures and controls are followed; also consults with the Claims Supervisors on claim areas needing improvement.
NewAuto Claims Manager Amtex Insurance & Constitution General AgencyAuto Claims ManagerHouston, TexasThe ideal candidate will have extensive experience in Texas auto claims , including Property Damage (PD), Bodily Injury (BI), Total Loss, and Subrogation , along with a proven track record of leading teams, improving processes, and delivering exceptional customer service. This role is responsible for driving operational excellence, ensuring quality claim handling, maintaining regulatory compliance, and developing a high-performing claims team.
NewMulti-Line Claim Supervisor- General Liability & Bodily Injury CCMSIMulti-Line Claim Supervisor- General Liability & Bodily InjuryDallas, TexasRemote$75,000–$100,000 / yearThe Multi-Line Claim Supervisor is responsible for providing technical leadership, claim oversight, and direct supervision for a team of approximately 2–5 adjusters handling general liability, premises liability, and bodily injury claims within a national account environment. Proven ability to provide technical claim leadership , including litigation oversight, reserve management, settlement authority support, claim strategy development, and mentoring of claim professionals handling complex claim inventories.
NewClaims Examiner I - Commercial Auto Athens AdministratorsClaims Examiner I - Commercial AutoSan Antonio, TexasAdditional duties may be assigned: Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills. Athens Position Details Position Title: Claims Examiner I – Commercial Auto Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all state except California Job Grade: 9 Career Ladder: Next step in progression could include Claims Examiner II ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976.
AVP, Claims- Personal Lines Hallmark Financial ServicesAVP, Claims- Personal LinesDallas, TexasThe AVP will provide oversight to all personal lines units and supervisors/managers responsible for adjusting 1st and 3rd party auto bodily injury and property damage claims; including collision, comp, total losses, salvage, subrogation, PIP, SIU and litigated claims. This position will oversee claims adjudication, drive process improvements using technology, ensure regulatory compliance, manage budgets, and lead teams to deliver timely, accurate, and cost-effective claims processing.
Claims Manager El Paso County, TexasClaims ManagerEl Paso, TX$76,593.71–$95,742.14 / yearEducation and Experience: Bachelor's Degree or higher in Business or Public Administration, Finance, Risk Management, Insurance, or a related field, and four (4) years of professional experience administering workers' compensation, property and casualty insurance claims, self-insurance, or captive insurance programs, including two (2) years of lead or supervisory experience. Regular employees in the City Service shall accrue vacation credit at the following rates per pay period, calculated from the date of employment of each employee: For 0 - 5 years of service (12 days): 40 hour per week employees - 3.70 hours per biweekly pay period.
Workers Compensation Claims Specialist CinemarkWorkers Compensation Claims SpecialistPlano, TexasThis exciting and important role will be integral in ensuring Cinemark’s Workers’ Compensation claims process is aligned with industry best practices, fits the company culture and business strategy, and provides great value to our team members. 7+ years of hands-on Workers’ Compensation adjusting experience, managing claims within a Risk Management Department or the Claims Department of an insurance carrier or Third-Party Administrator.
General Liability Claims Specialist Amtrust Financial Services IncGeneral Liability Claims SpecialistDallas, TXThe Claims Specalist is responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process for General liability claims within BI. Determines, reviews and analyzes coverages that may or may not apply to the claim; Plans, executes and reviews investigations-coverage, liability and/or damages - including the securing of a signed or recorded statement of the insured, claimant and/or witnesses.
Automotive Warranty Claims Adjuster iA AmericanAutomotive Warranty Claims AdjusterAustin, TexasiA American Warranty LP, American Amicable Group of Companies, iA American Life Insurance Company and Industrial Alliance Portfolio Management LLC are all part of iA Financial Group, one of the largest insurance and wealth management groups in North America. Applicants must be authorized to work for any employer in the U.S. We are unable to support or take over sponsorship of employment visas at this time, including H-1B visas and participation in STEM OPT work authorizations.
Claims Examiner Senior \ 160 Paladin Consulting, Inc.Claims Examiner Senior \ 160Irving, TX$22–$23 / hourThis role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Summary: The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations.
NewClaims Examiner & Support Specialist Level I HealthTexas Medical GroupClaims Examiner & Support Specialist Level ISan Antonio, TXThe Claims Examiner & Support Specialist Level I is responsible for accurately processing health plan delegated claims, addressing provider inquiries via phone calls, and handling various administrative tasks within the department. Additionally, maintaining a customer-centric approach when dealing with inquiries and issues is essential to ensure a positive experience for providers and stakeholders.
Senior Claims Adjuster, TPA Oversight The Fortegra Group IncSenior Claims Adjuster, TPA OversightTX$100,000–$130,000 / yearThe Senior Claims Adjuster, TPA Oversight will provide technical expertise and handle a wide variety of severity/complex claims as well as coverage litigation within Commercial Auto, Cargo, and Crane & Rigging lines of business. Additionally, they will complement the existing Specialty Claims team that supports the Underwriting unit and will provide oversight of third parties and delegated authority referrals.
NewClaims Examiner Sigma Systems, Inc.Claims ExaminerIrving, TexasServes as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management. This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.
NewClaims Examiner II - Commercial Trucking PD/BI Athens AdministratorsClaims Examiner II - Commercial Trucking PD/BISan Antonio, TexasAdditional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. ATHENS POSITION DETAILS Position Title: Claims Examiner II Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976.
Medical Claims Resolution Specialist (Flexible schedule options) Aspire Allergy & SinusMedical Claims Resolution Specialist (Flexible schedule options)Austin, TexasWorks Insurance Accounts Receivable reports per Revenue Cycle Manager work plan beginning with >120 aging top dollar working in descending order. Excellent mathematical skills, computer skills, Microsoft applications and word processing programs skills and a minimum of 40 words per minute required.
Medical Biller - Hospital Claims - Healthcare Guidehouse IncMedical Biller - Hospital Claims - HealthcareSan Antonio, TXDemonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. 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.
38119 Medical Biller - Hospital Claims - Healthcare Guidehouse Inc38119 Medical Biller - Hospital Claims - HealthcareSan Antonio, TXDemonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. 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 Team Lead, Auto Sedgwick Claims Management Services, Inc.Claims Team Lead, AutoTXPRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Skills & knowledge: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, leadership/management skills, analytical and interpretive skills, ability to work in a team environment, and the ability to meet or exceed Performance Competencies.
Claims Team Lead, Auto | Complex Bodily Injury Sedgwick Claims Management Services, Inc.Claims Team Lead, Auto | Complex Bodily InjuryTXPRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Skills & knowledge: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, leadership/management skills, analytical and interpretive skills, ability to work in a team environment, and the ability to meet or exceed Performance Competencies.
Claims Team Lead | Commercial Trucking | Remote Sedgwick Claims Management Services, Inc.Claims Team Lead | Commercial Trucking | RemoteTXRemotePRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Skills: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including, Microsoft Office products, and leadership/management skills.
Claims Examiner Senior \ 160 TalentBurst, Inc.Claims Examiner Senior \ 160Irving, TX$23–$24 / hourThis role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
Claims Resolution Specialist (Hybrid) External BrandClaims Resolution Specialist (Hybrid)Austin, TexasUses denial data and reporting tools to trend payor denials to identify areas of improvement in Epic Practice Management system, worfklows within operations, or items that require leadership intervention for escalation. Maintains and follows up on accounts appropriately and clearly and accurately documents issues, sources and actions taken to describe activities and results in Account Contact.
Claims Investigator Texas Health and Human Services CommissionClaims InvestigatorEL PASO, TX$3,409.83–$4,252BPI Claims Investigators perform moderately complex investigative work regarding recipients of HHS programmatic services, such as Medicaid; the Children's Health Insurance Program (CHIP); the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); and the Women, Infants, and Children's (WIC) program. Graduation from an accredited four-year college or university with major coursework in business, public administration, criminal justice, or a field related to the assignment OR three years' experience in applying SNAP, TANF, and Medicaid policies, procedures, and regulations is required.
Adjuster Commercial P and C Claims CopperPoint Insurance CoAdjuster Commercial P and C ClaimsTX$55,000–$85,000 / yearWith a high degree of autonomy, you will play a key role in driving successful claim outcomes, protecting our insureds, and contributing to best practices that support CopperPoint's reputation for excellence and expertise. Leveraging your technical expertise, analytical skills, and sound judgment, you will make informed coverage and liability decisions while delivering exceptional service to policyholders and claimants.
Express Claims Adjuster Amwins Global Risks UK LtdExpress Claims AdjusterPlano, TXResponsibilities: Establish timely contact and build rapport with all applicable parties to a claim (insureds, drivers, witnesses, etc.), gathers facts of the loss and clearly explains the claims process. In the fast-paced environment of auto claims, this role requires strong oral, written, analytical, decision making and organizational skills and lends itself to considerable career growth potential.
Transportation Claims Representative AmTrust Financial Services, Inc.Transportation Claims RepresentativeDallas, TexasFull timeResponsibilities: Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimants or injured workers, witnesses and producers. Overview: The Transportation Liability Claim Representative is responsible for prompt efficient review and disposition of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds or claimants.
Claims Examiner - Workers Compensation Retail IndustryClaims Examiner - Workers CompensationDallas, TexasRemoteTo 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. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
NewClaims Examiner & Support Specialist Level I HealthTexas Primary Care DoctorsClaims Examiner & Support Specialist Level ISan Antonio, TexasThe Claims Examiner & Support Specialist Level I is responsible for accurately processing health plan delegated claims, addressing provider inquiries via phone calls, and handling various administrative tasks within the department. Additionally, maintaining a customer-centric approach when dealing with inquiries and issues is essential to ensure a positive experience for providers and stakeholders.
2027 Claims College Internship - North Richland Hills, TX Federated Mutual Insurance Company2027 Claims College Internship - North Richland Hills, TXNorth Richland Hills, TexasThroughout our internship program you will have an opportunity to learn claims processes and procedures, develop various skills related to teamwork, customer service, communication, multi-tasking, and decision-making, as well as participate in team meetings, office events, and community volunteering! Support Claims personnel in our Auto, Liability, Property and Workers' Compensation offices (as applicable) with telephone coverage and incoming and outgoing correspondence, as directed.
Cash Poster - Payment Posting - Healthcare Claims Guidehouse IncCash Poster - Payment Posting - Healthcare ClaimsSan Antonio, TXWhat You Will Do: The Cash Applications / Poster Specialist - Under general supervision and according to established policies and procedures, performs a variety of duties related to the payment posting function of the Management Services Organization (MSO). 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.
Patient Account Representative - Physician Claims Guidehouse IncPatient 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.
38119 Medical Biller - Hospital Claims - Healthcare Guidehouse38119 Medical Biller - Hospital Claims - HealthcareSan Antonio, TexasDemonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. 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.
Medical Biller - Hospital Claims - Healthcare GuidehouseMedical Biller - Hospital Claims - HealthcareSan Antonio, TexasDemonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. 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.
Associate Claims Examiner, Cyber Claims Markel Group IncAssociate Claims Examiner, Cyber ClaimsPlano, TX$27.84–$38.27 / hourThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Pay information: The hourly rate offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors.
Manager, Claims Data Analytics GEICO GENERAL INSURANCE COMPANYManager, Claims Data AnalyticsDallas, TXGEICO is looking for a highly motivated, innovative, and detailed leader to fill the role as a SIU Manager in enterprise fraud analytics who has a passion for managing individuals and building a best-in-class analytics and reporting suite. Must have the following education and experience: Must have 3+ years experience managing leadership associates while being responsible for the development, execution and outcomes of business plan initiatives.
2027 Claims College Internship North Richland Hills, TX Federated Service Insurance Company2027 Claims College Internship North Richland Hills, TXNorth Richland Hills, TXThroughout our internship program you will have an opportunity to learn claims processes and procedures, develop various skills related to teamwork, customer service, communication, multi-tasking, and decision-making, as well as participate in team meetings, office events, and community volunteering! Requirements/Qualifications • Current Junior academic standing in pursuit of a Business or Criminal Justice Bachelor degree • Minimum overall GPA of 3.0 • Strong computer knowledge • Ability to use Microsoft Excel or equivalent spreadsheet software.
Sr. Workers' Compensation Claims Professional Tesla IncSr. Workers' Compensation Claims ProfessionalAustin, TXManage catalogue of open workers' compensation claims to focus on cost mitigation and reducing liability through continued medical treatment activity, targeted return-to-work efforts, and ongoing case progression; provide settlement authority within limits. Support the internal benefits team with reviewing temporary and permanent disability benefits pertaining to workers' compensation claims,excused and unexcused absences, FMLA exhaustion and denials, short-termdisability claims, and long-term disability claims.
Claims Resolution Specialist Internal Resolution Unit- Health Plan Parkland HospitalClaims Resolution Specialist Internal Resolution Unit- Health PlanTXStays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. For staff in clinical roles, foster collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination.
NewClaims & Appeals Specialist II Driscoll Children's HospitalClaims & Appeals Specialist IICorpus Christi, TexasThe Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. A.) or equivalent from two-year college or technical school; three to five years related experience and/or training; or equivalent combination of education and experience.