- Sedgwick (Fort Worth, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others;...degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI),… more
- AIG (Dallas, TX)
- …AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Claims Director to play your part in that transformation. It's an ... to succeed + 7 plus years of General Liability/Auto claims experience. + Experience with complex and high exposure General Liability Bodily Injury and Property… more
- Mass Markets (Dallas, TX)
- …trusted partner in the industry. We are seeking an experienced Insurance Call Center Claims Director experienced in Property and Casualty and Life insurance to ... support complex business process outsourcing accounts. You will be responsible...monitor, and manage production to ensure accurate and timely claims processing. This is a senior-level position requiring experience… more
- Humana (Austin, TX)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision Health (OPH) is the next step ... health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for...with other members of the OPH Legal team on complex matters and matters of first impression, as well… more
- Evolent (Austin, TX)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected… more
- Humana (Austin, TX)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Prime Healthcare (Farmers Branch, TX)
- …trends and identify opportunities for process improvement and reimbursement optimization. + Complex Claims Management: identifies, trends, and owns portfolios of ... complex claims , including Third party claims , TDRG, Zero Balance, and assists in the remediation of denial trends, including coordination with other… more
- Humana (Austin, TX)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Humana (Austin, TX)
- …relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation and… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- ** Director , Medical Affairs Congress Strategy and Execution** The Director , Medical Affairs Congress Strategy and Execution, plays a pivotal role in Otsuka's ... elevate our overall GMA objectives. **Position Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations, this role will orchestrate… more
- WTW (Dallas, TX)
- …a key member of WTW's Health and Benefits (H&B) team, the Associate Director will support the National Dental and Vision Practice in delivering strategic, ... This role requires strong analytical and quantitative capabilities to interpret claims data, model financial outcomes, and support benefit modernization strategies.… more
- MD Anderson Cancer Center (Houston, TX)
- …students, trainees, professionals, employees and the public. The primary purpose of the Director , s for Hospital Billing and Collections is to manage and coordinate ... daily operations, which consists of billing all technical UB-04 claims with gross revenues in excess of $12 billion and cash collection in excess of $5.3B.… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …for the maintenance of everyday health** **As the** **Associate Director ,** **Statistical** **Programming** **, you will** **be** **responsible for** **managing** ... **managing** **and develop** **ing** **programmers.** **This position reports to the Director of Statistical Programming and can be based in Rockville, Maryland… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- The Associate Director , TLL, Renal Rare Disease, is a field-based, customer facing, non-sales position on Otsuka's Rare Renal team focused on enhancing and improving ... present and educate/present to KOLs and customer groups on complex and scientific/clinical information. + Assess and understand KOL...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Travelers Insurance Company (Houston, TX)
- …in a courtroom, boardroom, or other legal or administrative venue. As the Director , Forensic Accounting, Claim, you will lead a team of professional accountants to ... quantify the financial aspects of customer claims to ensure current, accurate, and complete information. You will leverage your accounting background and leadership… more
- Evolent (Austin, TX)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... insights. We value curiosity, creativity, and independence, working collaboratively to solve complex challenges and enhance the impact of our specialty programs and… more
- Evolent (Austin, TX)
- …humility, adaptability, intellectual curiosity, and accountability as we solve complex business problems. **Collaboration Opportunities:** The Director , ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- WTW (Dallas, TX)
- …in the North American market to join as a Property & Casualty (P&C) Director in our Insurance Consulting and Technology (ICT) practice. You will have experience in ... full potential. In this role you will collaborate with our team of pricing, claims , distribution, product management, underwriting and claims experts to sell and… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and congresses, ... messages succinctly + Understand detailed technical information and convey complex ideas to a variety of audience types and...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more