- OneMain Financial (Fort Worth, TX)
- ** Claims Examiner ** The Claims Examiner is responsible for evaluating and processing claims on primarily one business/product line by performing all ... correspondence to internal/external customers. **In the Role** + Evaluate claims against eligibility requirements, provisions and applicable processes. + Enter… more
- Sedgwick (Irving, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability | Dallas, TX (Hybrid) Are you looking for an ... **ARE YOU AN IDEAL CANDIDATE?** To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims … more
- Sedgwick (Fort Worth, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - (Hybrid/Agile Schedule - Auto w/ Litigation Experience) + ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- Sedgwick (Fort Worth, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner , Bodily Injury **PRIMARY PURPOSE** : To analyze complex or ... technically difficult general liability claims to determine benefits due; to work with high...to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication… more
- Sedgwick (Fort Worth, TX)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability (Multi-State Licensing Preferred - Hybrid - Sedgwick ... one. **PRIMARY PURPOSE** **:** To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims … more
- Sedgwick (Plano, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation - IL - Location - Plano, TX - ... PURPOSE OF THE ROLE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims … more
- Sedgwick (Fort Worth, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Auto/Bodily Injury **PRIMARY PURPOSE** : To analyze and ... process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of… more
- Sedgwick (Plano, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability (Agile/Hybrid Schedule - TX or WI) Are you ... PURPOSE OF THE ROLE:** To analyze commercial auto bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims Examiner to join our team in Plano, Texas (US-TX), United ... + Work independently to research, review and act on the claims + Prioritize work and adjudicate claims as per turnaround time/SLAs + Ensure claims are… more
- NTT America, Inc. (Plano, TX)
- …executed as part of an overall sourcing strategy. NTT DATA currently seeks a **Medical Claims Processor** to join our team in **Plano, TX for a remote position** . ... -Work independently to research, review, and act on the claims -Prioritize work and adjudicate claims as per turnaround time/SLAs -Ensure claims are… more
- CRC Insurance Services, Inc. (Fort Worth, TX)
- …responsible for investigating, evaluating, negotiating, and resolving personal lines property claims . Responsible for adjusting major and complex losses in their ... entirety, including high dollar claims . May also adjust standard losses. **ESSENTIAL DUTIES AND...2. Responsible for providing exceptional customer service and handles claims in accordance with prescribed authority and best … more
- Molina Healthcare (Fort Worth, TX)
- …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication, Claims Examiner II, or other relevant work ... **Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines,… more
- 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 (Fort Worth, TX)
- …Workplaces in Financial Services & Insurance General & Product Liability Complex Claim Examiner - Multi-State Preferred - Hybrid - Sedgwick Office **ARE YOU AN IDEAL ... - Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims … more
- 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 (Fort Worth, TX)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Product Liability (Frisco, TX - Hybrid...OF THE ROLE:** To analyze low level product liability claims on behalf of our valued clients to determine… more
- Molina Healthcare (Fort Worth, 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
- Sedgwick (Fort Worth, 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
- Molina Healthcare (Fort Worth, 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 (Fort Worth, 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