UNKNOWN

ADAPTED_NOW

Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Work cooperatively with Configuration in testing of contracts used in business operations and reporting to assure auto adjudication.

University Health

Claims Analyst

TMP PX

Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project coordination through research, data collection and analysis to identify areas for increased operational efficiency, productivity and accuracy.

Senior Claims Analyst

Develops claim procedure improvement methodology(s), directions and strategic plans for procedural improvement to support Community First Health Plans’ (Community First) business plan. Provides written and telephonic resolutions to external customer issues (with both providers and members) in accordance with the health plan’s policies and procedures.

Senior Manager, Claims - CFHP

The ideal candidate brings a proven track record of expert testimony, deep subject matter expertise in Medicare Severity Diagnosis-Related Groups (MS-DRGs) and inpatient billing practices, and the ability to lead complex engagements while developing junior staff in a highly leveraged consulting model. Provides subject matter leadership on MS-DRG classification systems, grouper logic, ICD-10-CM/PCS coding frameworks, Medicare IPPS rules, CMS regulatory guidance, and commercial payer reimbursement policies impacting inpatient claims.

YEAR

Bdo Consulting

Director, Forensics Healthcare

Ivy Exec

Across the healthcare ecosystem, we’re helping our clients unlock critical insights to track detailed patient behaviors and treatment patterns, identify gaps in care, address unmet patient needs, and reduce the global burden of disease. Healthcare or regulated data experience (claims, EHR, patient journeys, provider analytics), or a track record of getting fluent fast in a comparably complex data domain like supply chain, energy, or financial data.

Komodo Health

Principal Product Manager, AI Products

FEED

OTHER

Responsibilities: Build and configure automated claim statusing workflows using ANSI ASC X12 EDI transactions (276/277), including clearinghouse integration, 999/277CA acknowledgment ingestion, and payer statusing bridges. Configure and maintain the Claims build, Claim Definition files (CDF), payer output formats (CMS-1500 / 837P), claim edit rules, and validation criteria to drive first-pass clean claim rates.

ZipStaff Inc.

EPIC PB Claims Analyst (Claims Certification)

Betterteam

Investigate and resolve temperature-controlled freight claims involving reefer temperature deviations, pulp readings, transit delays, shelf-life deterioration, and USDA inspection results, applying PACA guidelines and the Carmack Amendment. Oversee operational risk workflows for rejected, stranded, or high-risk perishable loads, coordinating real-time reefer temperature deviation reviews, offsite restacks, and carrier holds or decertifications to prevent financial loss.

Arrive Logistics

Arrive Fresh Claims Analyst

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Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Guidehouse Inc

GLD Loss Claims Analyst (Managed Services)

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Our 20+ Team Member Business Resource Groups are focused on connecting our team members to our customers, suppliers, communities and shareholders, helping team members reach their full potential and creating an inclusive work environment to meet and exceed the needs of our diverse world. Also responsible for maintaining effective relationships with insurance carriers and defense counsel, In Flight, Airport Operations, Safety, Legal, Customer Relations and Corporate Communications.

American Airlines Mexico

Analyst/Sr Analyst, Risk Management Claims (Fort Worth, TX, US)

American Airlines

Complete LOMA 1 & 2 (280 & 290) courses, Associate, Customer Service (ACS) designation and working toward the Associate, Life & Health Claims designation (ALHC). Customer Service and Communication: Answer and respond to inbound telephone inquiries from policy beneficiaries or their representatives and provide excellent service during their claims inquiries.

Citizens Inc

Claims Analyst I - Domestic

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets: experience and training: licensure and certifications: and other business and organizational needs. Position Overview: The Claims Analyst plays a critical role in the Primary Casualty division, supporting the AVP - Primary Casualty Claims in the effective evaluation, investigation, and resolution of casualty claims.

Starr Companies

Claims Analyst - Primary Casualty

In addition to base salary, Voya offers incentive opportunities (i.e., annual cash incentives, sales incentives, and/or long-term incentives) based on the role to reward the achievement of annual performance objectives. At Voya, we have identified the following critical skills which are key to success in our culture: Customer Focused: Passionate drive to delight our customers and offer unique solutions that deliver on their expectations.

Voya Financial Inc

Senior Claims Analyst Leave & Disability

Conducts complex cross-functional investigations involving Accounting, Finance, Legal, Warranty, and other business partners to validate reimbursement claims, assess liability exposure, ensure due diligence, and maintain accurate records in support of organizational and regulatory requirements. Analyze transportation claim data and 3PL performance trends to identify recurring issues, improve reporting visibility, and support operational improvements while maintaining monthly KPI performance charts or graphs to identify improvement areas and best practices.

Kubota Corp

Claims Analyst II

Collaborates with duties related to the claim audit process, this includes but is not limited to claim analysis, site visits, document preparation and proper file storage. Essential Functions: Processes claims utilizing data entry and adjudication; executes claims' adjustments when needed.

APS Healthcare Puerto Rico Inc

The Senior Auto Claims Analyst is a senior individual contributor responsible for governing claim outcomes, coverage interpretation, and operational consistency for vehicle service contract programs and other ancillary products related to the auto industry. This role provides technical authority, analytical leadership, and escalation oversight to ensure claims are handled accurately, consistently, and in full compliance with contract terms, regulatory requirements, and internal controls.

Assurant, Inc. (NYSE: AIZ) is a global provider of risk management solutions, protecting where consumers live and the goods they buy. A Fortune 500 company, Assurant focuses on the housing and lifestyle markets, and is among the market leaders in mobile device protection; extended service contracts; vehicle protection; pre-funded funeral insurance; renters insurance; lender-placed homeowners insurance; and mortgage valuation and field services. With approximately $30 billion in assets as of March 31, 2016 and $8 billion in annual revenue for the year ended 2015, Assurant is located in 16 countries, while its Assurant Foundation works to support and improve communities. Learn more at <a href="http://www.assurant.com/" target="_blank" mns_rt="Company" itemprop="url">www.assurant.com</a> or on Twitter <a href="https://twitter.com/assurantnews" target="_blank" mns_rt="NonJob" itemprop="url">@AssurantNews</a>.

Assurant

Sr. Auto Claims Analyst

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.

<p><em>AIG and its member companies form one of the world’s leading insurance organizations. We provide insurance for businesses and individuals, helping individual customers plan for their futures by offering life insurance, travel insurance, product warranty, auto insurance and retirement products. Our commercial clients have come to rely upon our risk expertise and financial strength to help them address some of their most complex challenges – from huge construction projects to protecting themselves from the emerging threats to data security. We offer our people the chance to grow in a dynamic company that values teamwork, fresh perspectives, and a commitment to helping their clients.</em></p>

American International Group

Claims Management Analyst

American International Group Jobs

Harris Health is among an elite list of health systems in the U.S. achieving Magnet nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); and The University of Texas MD Anderson Cancer Center. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services.

Harris Health is a nationally recognized health system comprising three teaching hospitals and an extensive network of ambulatory care centers serving the people of Harris County, Texas, since 1966. Staffed by the faculty, fellows and residents from two nationally ranked medical schools, Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth), Harris Health is the first healthcare system in Houston to receive the prestigious National Committee for Quality Assurance (NCQA) designation for its network of patient-centered medical homes.

Each year, Harris Health provides more than 1.8 million total outpatient visits through its more than 40 ambulatory care facilities. Additionally, Harris Health sees more than 177,000 emergency visits at its Level 1 and Level 3 trauma centers and 35,000 hospital admissions through its three hospitals: Ben Taub, LBJ and Quentin Mease. Established by voter referendum to enhance the level of charity care available in the community, Harris Health System has often received national recognition for serving those in need and for its achievements in operational excellence, such as being named to the 2011, 2012, 2013 and 2014 Most Wired Hospitals lists by the American Hospital Association's Hospitals & Health Networks magazine.

Additionally, Harris Health System is pleased that each of its three hospitals: Ben Taub, Lyndon B. Johnson and Quentin Mease - achieved Pathway to Excellence designation by the American Nurses Credentialing Center.

Claims Analyst Jobs in Texas

Claims Analyst University Health

Senior Claims Analyst University Health

Senior Manager, Claims - CFHP University Health

Director, Forensics Healthcare Bdo Consulting

Principal Product Manager, AI Products Komodo Health

EPIC PB Claims Analyst (Claims Certification) ZipStaff Inc.

Arrive Fresh Claims Analyst Arrive Logistics

GLD Loss Claims Analyst (Managed Services) Guidehouse Inc

Analyst/Sr Analyst, Risk Management Claims (Fort Worth, TX, US) American Airlines Mexico

Analyst/Sr Analyst, Risk Management Claims (Fort Worth, TX, US) American Airlines

Claims Analyst I - Domestic Citizens Inc

Claims Analyst - Primary Casualty Starr Companies

Senior Claims Analyst Leave & Disability Voya Financial Inc

Claims Analyst II Kubota Corp

Claims Analyst APS Healthcare Puerto Rico Inc

Sr. Auto Claims Analyst Assurant

Claims Management Analyst American International Group

Epic Business Analyst III - Resolute Hospital Billing, Claims and Remittance Harris Health System

GLD Loss Claims Analyst (Managed Services) Guidehouse

Claims Analyst II Kubota Tractor Corporation

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