UNKNOWN

FEED

This onsite role plays a critical part in supporting accurate and timely insurance payment posting and account reconciliation across multiple practice management systems. Smile Brands is seeking an experienced and detail-oriented Insurance Payment Processor to join our Central Billing Office team in San Antonio, TX.

HOUR

Smile Brands Group Inc

Insurance Payment Processor

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Creates claim payments in the system, enters claim notes in the systems, maintains carrier transaction reports, and balances such for each carrier to ensure accuracy with the issuance of payments. Essential duties include the following: Receives new and continuing claims submitted, determines coverage under Payment Protection, sets them up in the systems, and prepares/disburses the claim files to the Examiners.

Southwest Business Corporation

Payment Protection Processor l

Payment Protection Processor L

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Creates claim payments in the system, enters claim notes in the systems, maintains carrier transaction reports, and balances such for each carrier to ensure accuracy with the issuance of payments. Receives new and continuing claims submitted, determines coverage under Payment Protection, sets them up in the systems, and prepares/disburses the claim files to the Examiners.

SWBC

WEEK

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

<p>Pride Global is a minority-owned integrated human capital solutions firm headquartered in New York with operating companies throughout the United States, Canada, India and Brazil. Pride Global companies focus on a diverse array of services including vendor management, payroll programs, business process optimization, and staffing for both direct hire and contingent labor.</p>

Pride Global

Healthcare Claims Supervisor

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Based on working knowledge of performance objectives associated with multiple job roles, provide coaching and feedback to management on progress of an individual learner and a group on their ability to best apply knowledge, skills, tools and job processes. What Will You Be Doing: Training of New Hires: Deliver and facilitate in person and virtual training spanning Customer Service and Claims Processing for multiple job roles for various client groups and blocks of business.

Guide Well

Claims Training Mentor

Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Develops a working knowledge of commercial insurance and learns to manage an inventory of low complexity claims by successfully completing a formal training program, and following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit. After successful completion of a formal training program, this individual contributor position works under close supervision, and within defined authority limits, to handle and resolve low complexity commercial claims for a specific line of business.

YEAR

CNA Financial Corp

2027 Claim Trainee Program - Associate Claims Representatives

REQUIRED QUALIFICATIONS: 5+ years general liability claim handling experience; Consultant: Experience with commercial general liability claims; Specialist: Experience with environmental or other latent injury claims or claims under affirmative pollution coverages; Experience in handling affirmative/defensive risk transfer; including additional insured tenders; Strong to Excellent verbal and written communication skills; Strong to Excellent analytical and critical thinking ability; Ability to present in a roundtable setting with a well-reasoned and analytical evaluation; Superior customer service skills and active listening skills; Proven track record of prioritizing and managing multiple responsibilities; Proven track record of effective negotiations/settlement of high-value general liability claims; Demonstrated negotiation and conflict resolution skills; Proficiency with MS Office, especially Word and Excel; Proficiency handling litigated claims; Active Property & Casualty State Insurance Adjuster license or ability to obtain licensing within 3 months of hire. The Claim Specialist and Claim Consultant roles are advanced claim handler positions within the ENVIRONMENTAL unit of The Hartford's Complex Claims Unit (CCU), responsible for the management of various complex claims brought against The Hartford's insureds.

The Hartford Insurance Group Inc

Complex Claims Unit Environmental - Claim Consultant or Specialist

GuideWell Mutual Holding Corp

As a Claims Supervisor, you'll manage and direct the activities of a team of Claims Examiners and Claims Benefits, and handle claims processing concerns and issues requiring a high degree of appropriate knowledge, creativity, research and communication with internal and external resources to achieve timely resolution. Guided by our HEART values of Humility, Excellence, Accountability, Respect, and Trust, we strive to create a workplace where teammates feel valued, supported, and empowered to do their best work every day.

Texas Children's Hospital

Claims Supervisor

Smile Brands supports over 650 affiliated dental practices across 28 states all focused on a single mission of delivering Smiles For Everyone!® Smiles for patients, providers, employees, and community partners. This onsite role plays a critical part in supporting accurate and timely insurance payment posting and account reconciliation across multiple practice management systems.

Smile Brands

[AW]-iCims

The Supervisor will be responsible for coaching and developing Medical Claims Processors, monitoring productivity and quality, reviewing work, resolving escalated cases, and ensuring the team consistently follows client requirements, documented procedures, and business rules. We are seeking an experienced Medical Claims Processing Supervisor to lead a team responsible for insurance verification and benefits research supporting patients prescribed complex and high-cost drug therapies.

Datamark, Inc.

Medical Claims Supervisor

Workable

FULL_TIME

For over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees â€" a goal that has allowed IMO to grow from Texas into multiple other states including Arkansas, Oklahoma, and New Mexico. IMO is a trusted managed care partner for both private and public enterprise with vast experience in quality case management and positive injured employee outcomes.

Injury Management Organization, Inc

Medical Data Entry Processor

Talent Acquisition

Regularly monitors Claims Examiners and Claims Benefits Specialists using the weekly productivity log to ensure Claims Examiners and Claims Benefits Specialists are performing within Claims Administration’s production goals and identify any individual coaching or group training for long-term performance improvement and teamwork. The ability to work well in a team environment and adopt a customer service perspective; excellent verbal and written communication skills; ability to interface with all levels of management, be detail oriented with the ability to multitask and display leadership skills.

Integrated Resources, Inc

Supervisor, Claims Dept.

We're looking for a Director, Product (Pharmacy Claims Platform) who brings deep experience developing pharmacy claims adjudication technology, understands how it works in a real-world PBM environment, and wants to help advance sophisticated pharmacy transaction capabilities. At least 8 years in product management or related platform roles, including at least 3 years directly accountable for the product requirements, priorities, and production delivery of a pharmacy claims adjudication engine or substantial core adjudication platform capabilities.

Prescryptive Health Inc

Director Product Pharmacy Claims Platform

OTHER

If you are a talented, experienced Claims Adjuster/Examiner with an active Texas Workers Compensation license looking for a door into a large organization submit your resume now! This position requires consistent in-office collaboration with internal staff, claimants, employers, and leadership to ensure timely and compliant claims administration.

TEEMA Group

Workers Compensation Claims Examiner

WorkWolf

Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.

<p>CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. </p>

CVS Health Corp

Senior Claims Benefit Specialist

Our employee-founded resource groups create communities within Arrive's walls, including Women in Logistics, Emerging Professionals, Prisms, Black Logistics Group, Salute and Unidos. The Associate Claims Examiner will professionally communicate with external parties and collaborate with internal teams, while also developing a basic grasp of the transportation industry and business acumen.

Arrive Logistics

Associate Claims Examiner

The ideal candidate can independently identify systemic gaps, translate complex operational issues into actionable technical requirements, and partner with Product and Engineering to drive sustainable solutions. End-to-End Adjudication Knowledge: Demonstrated expertise in claims adjudication workflows, benefit hierarchy, health plan configuration, pend rules, and identifying systemic processing gaps.

CollectiveHealth Inc

Senior Manager, Claims Systems

Manage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements. Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.

Claims Processor Jobs in Texas

Insurance Payment Processor Smile Brands Group Inc

Payment Protection Processor l Southwest Business Corporation

Payment Protection Processor L Southwest Business Corporation

Payment Protection Processor l SWBC

Healthcare Claims Supervisor Pride Global

Claims Training Mentor Guide Well

2027 Claim Trainee Program - Associate Claims Representatives CNA Financial Corp

Complex Claims Unit Environmental - Claim Consultant or Specialist The Hartford Insurance Group Inc

Claims Training Mentor GuideWell Mutual Holding Corp

Claims Supervisor Texas Children's Hospital

Insurance Payment Processor Smile Brands

Medical Claims Supervisor Datamark, Inc.

Medical Data Entry Processor Injury Management Organization, Inc

Supervisor, Claims Dept. Integrated Resources, Inc

Director Product Pharmacy Claims Platform Prescryptive Health Inc

Workers Compensation Claims Examiner TEEMA Group

Senior Claims Benefit Specialist CVS Health Corp

Associate Claims Examiner Arrive Logistics

Senior Manager, Claims Systems CollectiveHealth Inc

Claims Processing Manager - AI Trainer Mercor

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