- Mass Markets (Killeen, TX)
- …trusted partner in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- CVS Health (Austin, TX)
- … claims on HRP system in accordance with claim processing guidelines. Claims adjudication results should meet/exceed production and quality standards in line ... CMS and Aetna compliance and business requirements. Analyzes and approves routine claims that cannot be auto adjudicated. - Applies medical necessity guidelines,… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and entering the completed referral into the electronic medical record system for claims adjudication to ensure services are validated. Description of Duties + ... Position Information Posting NumberSRGV8223 Working TitlePRIOR AUTHORIZATION AND REFERRAL SPECIALIST (UT Health RGV Cancer and Surgery Center) Number of Vacancies1… more
- Elevance Health (San Antonio, TX)
- …II is responsible for reviewing, analyzing and processing policies related to claims events to determine the extent of the company's liability and entitlement. ... committees/hearings. + Summarizes and presents essential information for the clinical specialist or medical director and legal counsel. **Minimum Requirements:** +… more