- Sedgwick (Austin, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Claims Specialist , Medical Malpractice (LTC) **PRIMARY PURPOSE** ... : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Sedgwick (Austin, TX)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Claims Specialist , Professional Liability (A&E, D&O) **ESSENTIAL ... + Extensive knowledge and comprehension of insurance coverage + Claims expertise in medical malpractice, errors and...of insurance coverage + Claims expertise in medical malpractice, errors and omissions, directors and officers, life… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** The ** Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ... amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine… more
- CVS Health (Austin, TX)
- …handle customer service inquiries and problems. **Additional Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Austin, TX)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Molina Healthcare (Austin, TX)
- …complaints from Molina members, providers and related outside agencies. + Research claims appeals and grievances using support systems to determine appeal and ... grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business… more
- Baylor Scott & White Health (Pflugerville, TX)
- …+ Knowledge of patient registration procedures and documentation. + Knowledge of medical insurance claims procedures and documentation. Needs to have thorough ... vary based on position type and/or level **Job Summary** The Patient Services Specialist 3 offers advanced administrative support in a physician's office, clinic, or… more
- Highmark Health (Austin, TX)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Highmark Health (Austin, TX)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- HCA Healthcare (Austin, TX)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more