• Claims Examiner - Workers…

    Sedgwick (Austin, TX)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation REMOTE | California Experience Are you ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...**PRIMARY PURPOSE OF THE ROLE:** To analyze Workers Compensation claims on behalf of our valued clients to determine… more
    Sedgwick (07/15/25)
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  • Claims Examiner Workers Comp…

    Sedgwick (Austin, TX)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Comp I Remote I SE, Central, NE regions **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
    Sedgwick (06/29/25)
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  • Claims Examiner

    Sedgwick (Austin, TX)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner **PRIMARY PURPOSE** : To analyze and process complex auto and ... commercial transportation claims by reviewing coverage, completing investigations, determining liability and...RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are… more
    Sedgwick (07/18/25)
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  • Claims Team Lead -Liability

    Sedgwick (Austin, 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 (07/16/25)
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  • Senior Appeal Examiner (Meritain Health)

    CVS Health (Austin, TX)
    …with heart, each and every day. **Position Summary** The **Senior Appeal Examiner (Meritain Health)** is responsible for managing (to resolution) complaint and ... Qualifications** + 1+ years of experience with healthcare, specifically in appeals, claims , and/or compliance, as well as benefit interpretation. + 1+ years of… more
    CVS Health (07/19/25)
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  • Specialist, Configuration Oversight

    Molina Healthcare (Austin, 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 ... resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to… more
    Molina Healthcare (07/18/25)
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  • OSS Coordinator

    Sedgwick (Austin, TX)
    …& Insurance OSS Coordinator **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 (07/04/25)
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  • SIU Specialist - Remote in the California market

    Prime Therapeutics (Austin, TX)
    …Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the United States without the ... or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations/ claims experience. + Ability to manage workload while simultaneously working… more
    Prime Therapeutics (06/24/25)
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  • Investigator, Special Investigative Unit

    Molina Healthcare (Austin, 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 (07/19/25)
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