• Bodily Injury Claims Examiner

    Sedgwick (Dallas, TX)
    …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Bodily Injury Claims Examiner | Remote | Dedicated Client | Complex Claims ... Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
    Sedgwick (01/10/25)
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  • Claims Examiner Workers Compensation…

    Sedgwick (San Antonio, TX)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner Workers Compensation (Remote) with CA Claims Experience ... **PRIMARY PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within… more
    Sedgwick (12/14/24)
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  • Claims Examiner Workers Compensation…

    Sedgwick (Austin, TX)
    …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner Workers Compensation - TX, LA, OK, and AR **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
    Sedgwick (12/07/24)
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  • Claims Examiner - Auto

    Sedgwick (San Antonio, TX)
    …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner - Auto **PRIMARY PURPOSE** : To analyze and process ... complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
    Sedgwick (01/10/25)
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  • Claims Examiner - Property -…

    Sedgwick (Farmers Branch, TX)
    …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner - Property - In office Dallas, Tx. - Estimating ... complex or technically difficult (up to $100,000) personal and commercial line property claims by scoping damages and completing an estimate or by obtaining a… more
    Sedgwick (12/07/24)
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  • Claims Examiner

    Intermountain Health (Austin, TX)
    **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
    Intermountain Health (01/08/25)
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  • Bodily Injury and Litigation Auto Claims

    Amazon (Houston, TX)
    …program around the world across all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims professional to support our rapidly ... auto program. You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims with cross-functional… more
    Amazon (12/05/24)
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  • Claims Examiner

    TEKsystems (Richardson, TX)
    …sensitive groups to review and resolve customer problems and complaints concerning claims matters and personally handles the claim through resolution. * Proactively ... relating to the severity of the stated disability or incident. * Adjudicate claims in accordance with established policies and procedures. * Interview, make calls… more
    TEKsystems (01/09/25)
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  • Associate Analyst, Claims - Hybrid

    XPO, Inc. (North Richland Hills, TX)
    …skills Preferred qualifications: + 1 or more years of experience as a cargo claims examiner , analyst or in a similar capacity working with liability and ... Associate Analyst, Claims - Hybrid Requisition Id: 376916 Business Unit:...**What you'll need to succeed as an Associate Analyst, Claims at XPO** Minimum qualifications: + Bachelor's degree or… more
    XPO, Inc. (12/31/24)
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  • Claims Team Lead, Liability

    Sedgwick (San Antonio, TX)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
    Sedgwick (01/03/25)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Fort Worth, TX)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
    Sedgwick (12/19/24)
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  • Liability Claims Representative | Frisco,…

    Sedgwick (Frisco, TX)
    …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Frisco, TX (Hybrid Schedule) Are you looking for an… more
    Sedgwick (11/14/24)
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  • Specialist, Config Oversight

    Molina Healthcare (TX)
    …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...for at least one core operations function + Previous examiner , Adjuster/ processing experience in at least two +… more
    Molina Healthcare (12/05/24)
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  • OSS Coordinator

    Sedgwick (Austin, TX)
    …Suite 100, Austin, TX 78758.** **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense… more
    Sedgwick (01/04/25)
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  • Investigator, Coding SIU (Remote)

    Molina Healthcare (San Antonio, TX)
    …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
    Molina Healthcare (12/15/24)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Austin, TX)
    …investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC ... of two years of leadership experience + CFE (Certified Fraud Examiner ) or AHFI (Accredited Healthcare Fraud Investigator) **Additional Information** + Benefits… more
    Humana (12/19/24)
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  • Investigator, SIU

    Molina Healthcare (TX)
    …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are interested in… more
    Molina Healthcare (12/04/24)
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