Claim processor jobs in San Angelo, TX

- 384 jobs

All

Claim Processor

Claim Specialist

Claims Supervisor

Processor

Claim Processing Specialist

Claims Analyst

Medical Claims Analyst

Claims Supervisor (Bodily Injury)
Geico 4.1
Claim processor job in Richardson, TX
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through a @geico.com email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ***********************. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$49k-73k yearly est. Auto-Apply 2d ago
Legal Claims Analyst
Erisa Recovery
Claim processor job in Plano, TX
ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now. We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented. Essential responsibilities and duties Conducts legal research and investigation of claims Drafting legal documents Keeping track of changes in legal framework and providing timely updates on these changes Utilizes ERISA law enforcement Utilizes knowledge of health care standards appropriate to specific claim Ability to understand and apply medical reimbursement policies, procedures, and standards Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation Utilize a variety of EHR systems Thrives in a fast-paced environment Collaborates effectively with other team members Ability to adapt to changing needs Consistently applies knowledge relevant to claims Work intensely at a fast-paced rate Ability to communicate effectively with third party administrators Determine the status of medical claims through research Meet the standards of the department and quality standards Strong organizational skills Desired skills and Qualifications Bachelor's degree 3+ years working in the legal field 2+ years working with healthcare insurance claims (preferred) Strong Communication skills Working knowledge utilizing Microsoft software (Word, Excel, Outlook) Ability to work in a fast-paced environment Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Paid lunches Bonus ERISA Recovery is an Equal Opportunity Employer
$34k-55k yearly est. 20h ago
Specimen Processor
Pride Health 4.3
Claim processor job in Irving, TX
Pride Health is hiring a Pride Health is hiring a Specimen Technician to support our client's medical facility in Irving TX 75063. This is a 3 months+ assignment with the possibility of a contract-to-hire opportunity, and it's a great way to start working with a top-tier healthcare organization! Job Title: Specimen Technician Location: Irving TX 75063 Pay Range: $17-$18 per hour Schedule: Sunday thru Thursday 4 am- 12:30 pm (40 hours per week) Duration: 3 months+ Responsibilities: Perform specimen processing tasks including A-station, presort, pickup, delivery, imaging, centrifugation, and aliquoting. Enter data accurately and efficiently (6,000 keystrokes/hour). Ensure accuracy, timeliness, and compliance with test regulations. Maintain specimen organization and handle various specimen types correctly. Adhere to safety protocols in a biohazard environment. Meet productivity and quality standards in a production setting. Communicate effectively with team members and other departments. Keep work area clean and organized. Demonstrate flexibility with shifts, weekends, holidays, and overtime. Education/Qualifications: High School Diploma or GED. Prior laboratory experience preferred Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors.
$17-18 hourly 4d ago
Mortgage Claims Processor
Pennymac 4.7
Claim processor job in Fort Worth, TX
PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U. S. mortgage market. At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture. Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey. A Typical Day The Claims Processor will take direction from the department supervisor for post-sale functions, such as: evictions, property maintenance, conveyance of title, title delivery, and adherence to GSE servicing requirements during the REO process. As the Claims Processor, you will be responsible for filing MI, investor, and insurer claims timely and accurately, providing all back-up as requested, and the reconciliation and posting of claim proceeds. The Claims Processor will: Perform post-foreclosure servicing functions as required by MI, investor, insurer, and internal guidelines including: eviction management, property inspection and maintenance, conveyance of title, title delivery, maintenance of HOA, taxes, and property insurance during the GSE REO process File claims for reimbursement of expenses Reconcile claim proceeds File supplemental claims as needed Ensure data accuracy Perform other related duties as required and assigned Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring High School Diploma / GED 1+ years of relevant work experience Default-related experience preferred Demonstrated aptitude for data, reporting, and working with numbers, desired Familiar with GSE and Insurer servicing guidelines Must be highly proficient in Excel and Word Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home. Our vision is to be the most trusted partner for home. Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported. Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered. Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: ********************* page. link/benefits For residents with state required benefit information, additional information can be found at: ************ pennymac. com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance. Salary $39,000 - $55,000 Work Model OFFICE
$39k-55k yearly Auto-Apply 27d ago
Technical Claims Specialist
Berkley 4.3
Claim processor job in Texas
Company Details Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs. Company URL: *************************** The company is an equal opportunity employer. Responsibilities The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations. Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties. Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution. Demonstrate understanding of medical terms, medical treatment and injury descriptions. Recognition and evaluation of potential damages related to injuries. Manage the claim authorization process. Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence. Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements. Verify, analyze, and correctly apply coverage. Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law. Keep policyholders, underwriting and agents advised of file status and other matters as required. Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues. Successfully complete relevant continuing education as required. Qualifications Minimum of 7 years of multi-line experience Must possess a current Texas claims adjuster licenses; additional licenses a plus. Multi-jurisdictional experience preferred. Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws Ability to follow detailed procedures and ensure accuracy in documentation and data. Excellent written and verbal communications; with ability to listen well. Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution. Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders. Excellent organizational skills; ability to prioritize workload Ability to think critically and solve problems, including the ability to interpret related documentation Strong negotiation skills leading to best claim outcomes Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel Education Requirement Bachelor's Degree required or equivalent work experience. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $90,000 - $140,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
$90k-140k yearly Auto-Apply 1d ago
Insurance Claims Specialist
DPR Construction 4.8
Claim processor job in Dallas, TX
The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: Input and/or review all incidents reported in DPR's RMIS system. Maintain incident records in Insurance Team's document management system. Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. Provide in-network aluminum certified repair shop information to drivers following an incident. Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. Work with Insurance Controller on auto program claim reports Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training Ensure authorized driver list is kept current Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: Strategic thinking Ability to mentor and inspire others Integrity Team player Strong writing and communication skills Self-Starter Highly organized and responsive - ability to meet deadlines Detail Oriented Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. Risk and dispute management - insured claims Qualifications: A minimum of five years relevant insurance industry experience Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************
$57k-73k yearly est. Auto-Apply 60d+ ago
Executive Claims Examiner
Markel Corporation 4.8
Claim processor job in Plano, TX
What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority. Responsibilities: * High complexity coverage interpretation, liability investigation, multiple vehicles, potential extra-contractual, litigation or significant injuries. * Direct involvement in litigation claims management to reach desired outcomes and minimize expenses * Investigate, negotiate and settle complex liability cases. Maintain and make sure alignment to Markel's guidelines and procedures. * Ensure proper adherence to internal large loss reporting requirements. * Promptly communicate with Claims Manager on case developments and provide information on issues affecting the lines of business * Chip in and assist in the implementation of a range of initiatives, discussion and action plans brought forth by the Claims Manager * Connect with underwriting as needed to handle claims and to alert of any significant developments * Participate in agent related functions and meetings as required Requirements: * 7-10+ years of Liability claims handling experience with a commercial insurance company * Successful Liability claim handling experience is critical * College degree and/or professional designation preferred * Sound comprehension of personal and commercial liability coverages. * Excellent written and oral communication skills. * Experience in resolving contractual obligations, coverage analyses, and investigations. * Ability to run sophisticated large liability exposures, set loss and expense reserves and evaluate settlement values. * Ability to proactively self-manage an active caseload. * Ability to analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form. * Travel required as necessary (less than 15%). * Adjuster license in multiple states or across the US strongly preferred. US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $97,520 - $134,000 with a 25% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
$36k-50k yearly est. Auto-Apply 20h ago
Risk Claims Specialist
Maya Management Group LLC 4.1
Claim processor job in Dallas, TX
Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.
$37k-65k yearly est. 28d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim processor job in Plano, TX
Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
$82.8k-97.3k yearly Auto-Apply 60d+ ago
Claims Examiner
Partnered Staffing
Claim processor job in San Angelo, TX
At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Position title: Claims Examiner Length of contract: Temp to Hire Location: San Angelo, TX 76901 Pay Rate: $10.58/Hr Job Description: BASIC FUNCTION: Under supervision, this position is responsible for processing complex paper and electronically submitted claims requiring further investigation and coding; resolving pended claims and processing adjustments. Multi-task & decision making - navigating multiple computer applications - a lot of mouse functions - web based applications JOB REQUIREMENTS: 1) High School diploma or GED 2) At least one year office environment experience 3) Data entry and/or typing experience 4) Clear and concise written and verbal communication skills Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans
$10.6 hourly 14h ago
Paralegal/Claims Specialist
The Sundt Companies 4.8
Claim processor job in Irving, TX
JobID: 9100 JobSchedule: Full time JobShift: : As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1
$45k-61k yearly est. Auto-Apply 10d ago
Medical Coding Appeals Analyst
Carebridge 3.8
Claim processor job in Grand Prairie, TX
Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$44k-65k yearly est. Auto-Apply 60d+ ago
Claims Specialist
MSIG Holdings 4.1
Claim processor job in Addison, TX
MSIG USA continues to grow! MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks. Summary/Job Purpose: This position is responsible to conduct thorough investigations and evaluate and negotiate complex claims including litigation and coverage issues. Accountable to ensure compliance with MSMM Claim Handling Guidelines, including reserving and payment practices, regulatory requirements and Fair Claims Practices Acts. Essential Functions: Investigates, researches and analyzes highly complex or severe claims, including coverage issues and legal issues affecting liability and damages. Establishes appropriate case reserves, completes settlements and case resolutions within established reserve and settlement authorities. Recommends reserve and settlement values on assigned cases in excess of established reserve and settlement authority. Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claim practices and company policy and procedures. Attends pre-trials, trials, settlement conferences and mediations on assigned cases as required Assigns the defense of lawsuits to approved defense counsel; directs and monitors quality and performance of defense counsel. Maintains compliance with all requirements of the company's Litigation Management Program. Reviews and adjusts, where appropriate, fee bills and legal expenses for accuracy and reasonableness. Services the claim needs of our customers including insureds, claimants, brokers, etc., in accordance with company policy and procedures, and attends client visitations with underwriters and other parties to conduct presentations and reviews. Maintains ongoing communication with all customers throughout the claims process in an effort to provide timely and appropriate claim status as appropriate and/or required by statutory regulations. Completes timely and accurate data reports to state reporting agencies to ensured full compliance with MSMM and regulatory requirement. Maintains full compliance with all regulatory Fair Claim Practices Acts and state and federal regulations. Maintains full compliance with all state licensing and continuing education requirements to ensure current and appropriate filing/standing of all adjuster licenses. Maintains regular reporting of case status, developments and direction to Home Office staff and other appropriate parties as necessary. Ensures timely and appropriate file reports and system documentation as required by company claim manuals and procedures. Participates and/or manages special projects and assignments as needed. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and Experience Required: High School Degree or G.E.D. is required. Bachelor's degree preferred 7+ years related experience handling complex Liability or Workers' Compensation Claims It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group! It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.
$37k-65k yearly est. 60d+ ago
Claims Processing Specialist
Saferide Health
Claim processor job in San Antonio, TX
SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide's billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role. Responsibilities: Facilitates data processing and processes claims for NEMT and GMR rides. Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues. Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations. Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines. Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner. Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules. Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team. Served as the Billing team's subject matter expert and primary contact for claims related projects and critical activities. Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues. Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas). Champion and reinforce SafeRide's culture. Required Education/Experience: Minimum 1 years of experience in billing/claims management Must be bilingual Spanish Speaking Preferred NEMT/transportation background preferred Knowledge of CMS/HHSC regulations preferred Skills Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc. Self-starter, ability to work independently and in a team environment. Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions Ability to adapt to unforeseen circumstances quickly Keen attention to detail Ability to work with a variety of stakeholders What we offer you An inclusive, encouraging and collaborative company culture Strong support for career growth, including access to our investor communities Competitive compensation with upside for growth (including stock options and performance grants) Competitive benefits including health/vision/dental insurance, 401k match and 18 day's PTO About SafeRide Health: SafeRide's mission is to restore access and dignity to care. SafeRide is transforming access to care for the nations sick, poor and underserved. We are a high growth, tech enabled services firm that's growing past 400 employees. SafeRide is backed by premier investors like NEA and clients like Fresenius. We operate nationally and now deliver over 5M rides per year. Learn more at ***********************
$27k-36k yearly est. 38d ago
Provider Claims Infusion Specialist
Lantern 3.9
Claim processor job in Dallas, TX
Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. About You: You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with. You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change. Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. You thrive in a Team Environment. Collaboration is key in innovation and creating change. These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. If this sounds like you, we would love to connect to speak further about career opportunities at Lantern. Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process. Job Overview Our Reimbursement Specialists are a central points of contact for our provider network. The primary responsibility of the role is to deliver effective, accurate payment and communication to our providers. The day-to-day responsibilities of our Reimbursement Specialists include payment processing, researching, accurate billing/payment disbursement, and ensuring payment data accuracy and integrity. The desired candidate is articulate, empathetic, pragmatic, self-starting and ambitious. In addition, our Reimbursement Specialists are horizontal thinkers, analytical, organized and detail oriented. Key Responsibilities: Processes provider payments in accordance with company policies and procedures. Serves as primary contact to Finance Department regarding payment, determinations and payment processing activities. Assist in the final determination on claim disposition and payment determination. Serves as liaison to internal departments regarding provider related inquiries on claims related content. Processes adjustments or provider disputes providing timely follow-up. Coordinates research and responds to system inquiries from providers regarding payment, reimbursement determination, provider contact information and claims billing procedures. Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, reimbursement/payment errors or internal approvals. Works with provider contracting staff when new/modified reimbursement contracts are needed Performs pre-adjudication claims reviews to ensure proper terms and schedules were used. Initiate necessary actions regarding pending claims or payment documentation. Follow up on open items reports to timely and accurate resolution. Respond proactively to provider issues and concerns and give feedback to management. Provide feedback to the manager regarding proper claims billing procedures in accordance with company policy and procedures. Assist in training new Payment Specialists. Initiate change requests to resolve system issues impacting claims/payment processing or issue resolution Runs and analyzes daily activity reports. Analyze, develop and deliver claims resolutions quickly and accurately according to company policies and procedures. Requirements: Minimum Bachelor's degree in healthcare, business, marketing or related field; or HS Diploma (or GED) and 4 years' applicable experience Minimum 2 years of experience in previous claims, health insurance or healthcare practice Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) preferred Knowledge of commonly used medical data resources preferred Knowledge of payor contracts and interpretation Knowledge of general office operations and/or experience with standard medical insurance claim forms preferred Strong communication (verbal, written and listening), teamwork, negotiation and organizational skills Ability to commit to providing a level of customer service within established standards Ability to provide attention to detail to ensure accuracy including mathematical calculations Ability to organize workload to meet deadlines and participate in department/team meetings Ability to analyze data and arrive at a logical conclusion Ability to identify issues and determine appropriate course of action for resolution Ability to display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software Ability to work with accuracy in a fast-paced environment Ability to work independently and handle PHI and confidential information Ability to process detailed verbal and written instructions Benefits Medical Insurance Dental Insurance Vision Insurance Short & Long Term Disability Life Insurance 401k with company match Paid Time Off Paid Parental Leave Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.
$30k-35k yearly est. Auto-Apply 60d+ ago
Claims Specialist
Crouch Staffing Solutions, Inc.
Claim processor job in Waco, TX
Job Description Crouch Staffing Solutions, Inc. in Hewitt, Texas is hiring for a Claims Specialist for a Waco area company. All of our services are free for prospective employees. Location: Waco, TX 76710Job Title: Claims Specialist (Call Center) Job Type: Full-time Pay/Salary: $17.00 per hour Hours of Work: Monday -Friday, 8 AM - 5 PM ROLE SUMMARY:The Claims Specialist will be responsible in processing life, disability, and waiver of premium claims by providing patient, empathetic, customer service to policy-related personnel regarding their claim. This is handled via telephone, e-mail, fax, or by sending letters through the mail. In addition, perform the various claim functions as listed below. DAILY RESPONSIBILITITES: Collecting information through handling incoming calls, ensuring timely and courteous verification. Inform clients about processes, procedures, and expectations in a clear and helpful manner. Coordinate the necessary documentation for claims processing, utilizing both internal systems and external resources. Generate letters and update claim systems for newly reported claims. Address and follow up on outstanding requirements for pending claims, resolving them efficiently. Investigate and gather essential data from various sources such as beneficiaries, physician records, medical facilities, legal documents, etc., to facilitate effective claims processing. Record detailed notes related to interactions with policy-related personnel. REQUIREMENTS: Successful performance in this role demands the following qualifications. The criteria listed below illustrate the knowledge, skills, and abilities necessary. Reasonable accommodations may be considered for individuals with disabilities. Effective communication skills, both written and verbal. Proficiency in handling multi-line phone systems, with the ability to route and escalate calls as required. Exceptional interpersonal skills, fostering positive relationships. • Strong organizational and time management capabilities. • Patient and empathetic demeanor. • Active listening skills. • Adaptability and flexibility in dynamic work environments. • Comfortable working within fast-paced settings. • Troubleshooting skills, varying from basic to advanced based on role and industry. • Proficient computer skills, including data entry proficiency. • Adherence to all applicable laws, regulations, and contractual obligations while conducting company business with ethics and integrity, aligning with the Compliance Program principles. EDUCATION, WORK EXPERIENCE, and TRAINING REQUIREMENTS: • High School Diploma or general education degree (GED) is required • Preference for life claims experience, though not mandatory. • Prior experience in call centers and customer service is strongly preferred PLEASE APPLY AT www.crouchstaffing.com
$17 hourly 21d ago
Specimen Processor
Pride Health 4.3
Claim processor job in Lewisville, TX
Join Pride Health as a Specimen Technician/lab Assistant at Lewisville TX 75067 This is a 2.5 months contract role (with high possibility of extension or conversion) offering a great opportunity for experience to excel in a dynamic environment. Role: Specimen Technician /lab Assistant Location: Lewisville TX 75067 Shift Schedule: 10PM-630AM CST , Su We Th Fr Sa Pay Range : $17/hr to $17.88/hr Contract : 2.5 months + Possible extension... Job Description: The SPT I is responsible for general support functions within the Specimen Processing Department. This position requires a data entry background. Functions performed may include but are not limited to A-station, presort, pickup and delivery of processed specimens to the laboratory, imaging/microfilming, centrifugation and aliquoting. All functions must be performed with confidence, accuracy and in a timely manner. Job is complex and requires that employee have good organization skills and is able to learn and understand specimen types related to test(s) ordered by client. The SPT I must have to the ability learn and understand the compliance regulations related to test ordering which may change on a daily basis. This position is critical to quality for customer satisfaction. Additionally, since many changes do occur from day to day, great flexibility on the part of the SPT I is required. The SPT I will be exposed to many different demands made by the customer. Majority of SPT I work on the nightshift but based on staffing needs, weekends, holidays, on call and overtime availability is a requirement. Department is a production environment, with emphasis on productivity/quality standards and departmental completion times. Position requires data background with abilities to enter 6,000 alphanumeric keystrokes/hour. Works in a biohazard environment, practicing good safety habits. Able to sit or stand for long periods. Communicates effectively with all levels of staff. Adheres to core values, safety and compliance policies and procedures. Keeps work area neat and clean. Demonstrates strong interpersonal skills that foster a positive environment. Demonstrates flexibility and ability to adapt to change. Education: HS diploma or equivalent. Required Knowledge: Basic understanding of computers with a preferred knowledge of laboratory testing and/or laboratory specimen processing. Work Experience: required , but previous laboratory experience required. Medical background preferred which includes medical terminology applicable to a clinical laboratory. Previous hospital laboratory experience is a plus but not required. Previous experience in a production environment preferred. Interested? Apply now! About Pride Health Pride Health is Pride Global's healthcare staffing branch, providing recruitment solutions for healthcare professionals and the industry at large since 2010. As a minority-owned business that delivers exceptional service to its clients and candidates by capitalizing on diverse recruiting, account management, and staffing backgrounds, Pride Health's expert team provides tailored and swift sourcing solutions to help connect healthcare talent with their dream jobs. Our personalized approach within the industry shines through as we continue cultivating honest and open relationships with our network of healthcare professionals, creating an unparalleled environment of trust and loyalty. Equal Employment Opportunity Statement As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.
$17 hourly 1d ago
Claims Supervisor (Bodily Injury)
Geico 4.1
Claim processor job in Dallas, TX
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$49k-73k yearly est. 1d ago
Technical Claims Specialist
Berkley 4.3
Claim processor job in Houston, TX
Company Details Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs. Company URL: *************************** The company is an equal opportunity employer. Responsibilities The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations. Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties. Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution. Demonstrate understanding of medical terms, medical treatment and injury descriptions. Recognition and evaluation of potential damages related to injuries. Manage the claim authorization process. Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence. Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements. Verify, analyze, and correctly apply coverage. Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law. Keep policyholders, underwriting and agents advised of file status and other matters as required. Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues. Successfully complete relevant continuing education as required. Qualifications Minimum of 7 years of multi-line experience Must possess a current Texas claims adjuster licenses; additional licenses a plus. Multi-jurisdictional experience preferred. Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws Ability to follow detailed procedures and ensure accuracy in documentation and data. Excellent written and verbal communications; with ability to listen well. Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution. Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders. Excellent organizational skills; ability to prioritize workload Ability to think critically and solve problems, including the ability to interpret related documentation Strong negotiation skills leading to best claim outcomes Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel Education Requirement Bachelor's Degree required or equivalent work experience. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $90,000 - $140,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role
$90k-140k yearly Auto-Apply 60d+ ago
Claims Processing Specialist
Saferide Health
Claim processor job in San Antonio, TX
Job DescriptionSalary: SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRides billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role. Responsibilities: Facilitates data processing and processes claims for NEMT and GMR rides. Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues. Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations. Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines. Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner. Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules. Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team. Served as the Billing teams subject matter expert and primary contact for claims related projects and critical activities. Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues. Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas). Champion and reinforce SafeRides culture. Required Education/Experience: Minimum 1 years of experience in billing/claims management Must be bilingual Spanish Speaking Preferred NEMT/transportation background preferred Knowledge of CMS/HHSC regulations preferred Skills Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc. Self-starter, ability to work independently and in a team environment. Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions Ability to adapt to unforeseen circumstances quickly Keen attention to detail Ability to work with a variety of stakeholders What we offer you An inclusive, encouraging and collaborative company culture Strong support for career growth, including access to our investor communities Competitive compensation with upside for growth (including stock options and performance grants) Competitive benefits including health/vision/dental insurance, 401k match and 18 days PTO About SafeRide Health: SafeRides mission is to restore access and dignity to care. SafeRide is transforming access to care for the nations sick, poor and underserved. We are a high growth, tech enabled services firm thats growing past 400 employees. SafeRide is backed by premier investors like NEA and clients like Fresenius. We operate nationally and now deliver over 5M rides per year. Learn more at ***********************
$27k-36k yearly est. 9d ago

Learn more about claim processor jobs

How much does a claim processor earn in San Angelo, TX?

The average claim processor in San Angelo, TX earns between $24,000 and $59,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in San Angelo, TX

$37,000

$24,00010%

$37,000Median

$59,00090%

What are the biggest employers of Claim Processors in San Angelo, TX?

The biggest employers of Claim Processors in San Angelo, TX are:

Partnered Staffing

Job type you want

Full Time

Part Time

Internship

Temporary

Claim processor jobs in San Angelo, TX

Claims Supervisor (Bodily Injury)

Legal Claims Analyst

Specimen Processor

Mortgage Claims Processor

Technical Claims Specialist

Insurance Claims Specialist

Executive Claims Examiner

Risk Claims Specialist

Claims Specialist - Auto

Claims Examiner

Paralegal/Claims Specialist

Medical Coding Appeals Analyst

Claims Specialist

Claims Processing Specialist

Provider Claims Infusion Specialist