Claim specialist jobs in San Antonio, TX - 43 jobs

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. This is a Full time in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 * Anticipated Training Class Start Dates: 1/5/2026 or 2/2/2026 What is your impact? As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity. What Will You Be Doing: The essential functions listed represent the major duties of this role, additional duties may be assigned. * Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where applicable. * Reviews and processes insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic). * Incumbents are expected to meet and/or exceed qualitative and quantitative production standards. * Investigation and overpayment administration: * Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers. * Overpayment reviews and recovery of claims overpayment; corrected financial histories of patients and service providers to ensure accurate records. * Utilize systems to track complaints and resolutions. * Other responsibilities include resolving claims appeals, researching benefits, verifying correct plan loading. What You Must Have: * 2+ years related work experience. * Claims examiner/adjudication experience on a computerized claims payment system in the healthcare industry. * High school diploma or GED * Knowledge of CPT and ICD-9 coding required. * Knowledge of COBRA, HIPAA, pre-existing conditions, and coordination of benefits required. * Must possess proven judgment, decision-making skills and the ability to analyze. * Ability to learn quickly and multitask. * Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers. * Concise written and verbal communication skills required, including the ability to handle conflict. * Proficiency using Microsoft Windows and Word, Excel and customized programs for medical CPT coding. * Review of multiple surgical procedures and establishment of reasonable and customary fees. What We Prefer: * Some college courses in related fields are a plus. * Other experience in processing all types of medical claims helpful. * Data entry and 10-key by touch/sight What We Can Offer YOU! To support your wellbeing, comprehensive benefits are offered. As a WebTPA employee, you will have access to: * Medical, dental, vision, life and global travel health insurance * Income protection benefits: life insurance, Short- and long-term disability programs * Leave programs to support personal circumstances. * Retirement Savings Plan includes employer contribution and employer match * Paid time off, volunteer time off, and 11 holidays * Additional voluntary benefits available and a comprehensive wellness program Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ. General Physical Demands: Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.

SWBC is seeking a talented individual to review and evaluate incoming claims for payment or denial and acts as a liaison for the carrier and the financial institution. Why you'll love this role: This role allows you to help those who are dealing with difficult circumstances in their lives. Your help gives them a sense of relief in times of need. You will also have a team who is supportive and there to help at any time. Essential duties include the following: Adjudicates routine to moderately complicated Payment Protection claims and determines if benefits are payable or not; ensures claims are adjudicated within the customer service level standards established by the company with adherence to Prompt Payment of Claims Regulation respective to each state. Prepares letters and requests any information needed to make a determination on claims from insurance carrier, family, claimant, physicians, employers, and others. Submits all claims determined contestable to carriers for review and final determination. Calculates the benefit amount and ensures claims are not being overpaid or underpaid according to the provisions within the specific insurance certificate/policy form that describes the terms and conditions of the applicable coverage. Assists claimants or financial institutions via phone to answer questions, and documents such within the claim file. Maintains carrier guidance and administrative files, required logs to comply with carrier requirements, reviews and evaluates instructions provided by carriers and assists management with proper implementation. Completes request for refund form and submits to Premium Processing; verifies monthly outstanding loan balances for active and inactive financial institutions; and ensures that open accounts loan balances are verified every 6 months and closed accounts are verified each month; provides back-up assistance to the claims processor position for establishment and set-up of new claims. Serious candidates will possess the minimum qualifications: High School Diploma or equivalency. Some college course work in medical terminology or related field preferred. Minimum one (1) year of claims processing or related experience. Able to type at least 40 WPM accurately and know 10 key by touch. Working knowledge of word processing and spreadsheets preferably in Microsoft Word and Excel. Excellent organizational and interpersonal skills. Able to draft business letters. Able to read and understand medical records. Able to prioritize job duties and be detail oriented. Able to lift up to 10-20 lbs. of claim storage boxes. Able to move (push/pull) up to 50 lbs. of files and documents. Able to bend, stoop, and stand to perform filing duties. SWBC offers*: Competitive overall compensation package Work/Life balance Employee engagement activities and recognition awards Years of Service awards Career enhancement and growth opportunities Leadership Academy and Mentor Program Continuing education and career certifications Variety of healthcare coverage options Traditional and Roth 401(k) retirement plans Lucrative Wellness Program *Based upon employee eligibility Additional Information: SWBC is a Substance-Free Workplace and requires pre-employment drug testing. Please note, SWBC does not hire tobacco users as allowed by law. To learn more about SWBC, visit our website at ************* If interested, please click the appropriate apply button.

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.

Job DescriptionSalary: About Us Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry. We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers. At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth. The Role We are seeking a motivated and Licensed Public Adjuster in San Antonio, Texas to join our team in a hybrid, commission-based role. As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests. This position is designed to support all levels of experience: Newly licensed adjusters benefit from structured training, mentorship, and back-office support. Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation. Key Responsibilities Collaboratively solicit residential and commercial new claims and referral partners Sign, inspect, evaluate, and document property damage for residential and commercial claims Prepare, submit, and negotiate insurance claims on behalf of policyholders Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently Advocate for clients best interests and ensure fair settlements are achieved Maintain accurate records, reports, and claim documentation Deliver exceptional customer service while educating clients on the claims process Generate new business and efficiently close provided leads Required Qualifications Active Texas Public Adjuster license (or ability to obtain one) Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required Strong negotiation and communication skills Organized, detail-oriented, and able to manage multiple claims simultaneously Professional demeanor with a client-focused mindset Valid drivers license and reliable transportation for field inspections Compensation & Benefits Commission-based structure with unlimited earning potential Training and ongoing professional development Career growth opportunities within a supportive and collaborative team Hybrid work flexibility (field + office) Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments) The Rockwall Difference At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers. Key Advantages: Comprehensive adjuster onboarding and mentorship programs Professional ongoing sales training to close contracts faster and expand referral networks Proprietary lead generation sources and affiliate networks Automated client onboarding to reduce paperwork Access to advanced claims management software for streamlined workflows Hands-on field training for residential and commercial claims Xactimate training and estimate reviews to ensure complete assessments Seamless invoicing and fee collection support Regular updates on case law, legislation, and industry trends A collaborative team environment that promotes growth and shared knowledge Why Join Rockwall NPA 20+ years of insurance industry expertise 15+ years as a trusted, established firm Strong reputation and high staff retention Proprietary lead generation sources and long-standing affiliate networks Full support systems that empower adjusters to succeed A company culture built on professionalism, advocacy, and results

BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 20 locations in North America as well as India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. Title : Transaction Processing Representative Location : SAN ANTONIO TX 78249 Duration : 12 Months Job Description: Basic Qualifications: 1-2 experience with automotive warranty, policy and procedure 1-2 years experience with management systems used in automotive warranty and administration Overtime will be required Qualifications Preferred Qualifications: Technical and mechanical background Experience with management systems used in automotive warranty Administration Skills: Experience with coding warranty claims and warranty administration. Good verbal and written communication skills. Computer and excel skills Education: High school or equivalent work/military experience Additional Information Thanks & Regards, BCforward Recruitment Team

Full Time 12238 Silicon Drive Clerical Day Shift $18.75 - $24.25 /RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children's Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE High school diploma or GED equivalent is required. Two or more years of experience claim processing and/or billing experience required. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred. Knowledge of ICD-9, CPT 4 coding and medical terminology is required.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative, Auto **PRIMARY PURPOSE** : To analyze and process low to mid-level auto and transportation claims. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. + Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution. + Identifies and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim action/processing with insured, client, and agent or broker when appropriate. + Maintains professional client relations. + Performs coverage, liability, and damage analysis on all claims assignments. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Secure and maintain the State adjusting licenses as required for the position. **Experience** Three (3) years of personal line or commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics. Property estimating software experience a plus. **Skills & Knowledge** + Familiarity with personal and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims. + Knowledge of total loss processing, State salvage forms and title requirements. + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Service Expectations **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking **NOTE** : Credit security clearance, confirmed via a background credit check, is required for this position. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $50,000_ _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

**Why USAA?** At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated **Injury Examiner** , you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy. This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week. **What you'll do:** + Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims. + Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes. + Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates. + Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation. + Partners and/or directs vendors and internal business partners to facilitate timely claims resolution. + Serves as a resource for team members on complex claims. + Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication. + Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. + Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. **What you have:** + High School Diploma or General Equivalency Diploma. + 4 years auto claims and injury adjusting experience. + Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations. + Advanced negotiation, investigation, communication, and conflict resolution skills. + Demonstrated strong time-management and decision-making skills. + Proven investigatory, prioritizing, multi-tasking, and problem-solving skills. + Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims. + Ability to exercise sound financial judgment and discretion in handling insurance claims. + Advanced knowledge of coverage evaluation, loss assessment, and loss reserving. + Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts. **What sets you apart:** + 2 or more years of high-value catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality) to include UM/UIM coverage + College Degree (Bachelor's or higher). + Insurance Designation. **Compensation range:** The salary range for this position is: $85,040 - $162,550 **.** **USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).** **Compensation:** USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. **Benefits:** At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com _Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting._ _USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran._ **If you are an existing USAA employee, please use the internal career site in OneSource to apply.** **Please do not type your first and last name in all caps.** **_Find your purpose. Join our mission._** USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity. USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself - you just need to share our passion for serving our more than 13 million members. USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law. California applicants, please review our HR CCPA - Notice at Collection (********************************************************************************************************** here. USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.

Hi! I am a professional senior healthcare recruiting consultant placing healthcare professionals permanently in the United States. I am currently hiring for Claims & Denials Coordinators in the San Antonio area.This is for a Fortune 125 company. We have 5 Claims & Denials Coordinators positions available. I'm looking to hold my final batch of phone screenings tomorrow so apply now and please send your update resume directly. Position is Long Term Temp up to 6 months (after that position may end, get extended or go permanent based on business need), Schedule is Mon-Fri, 8:00am-5:00pm, some OT may be required. Will be working in office. Competitive pay and amazing benefits! Thanks, Ron Payos 321-332-6801 Job Description In charge of generating denial letters to explain to providers why services were not approved. Qualifications High school diploma or equivalent 2+ years of managed care experience (either working at a plan or interacting with a plan) Knowledge of medical terminology Knowledge of claims, appeals, & denials Computer skills Administrative experience Additional Information All your information will be kept confidential according to EEO guidelines.

Schedule: Monday - Friday, 9:00 AM - 6:00 PM Pay: $19.00 - $20.00 hour (based on experience) + Quarterly Bonus Eligibility We're looking for a detail-oriented and motivated Eligibility Screener / Insurance Follow-Up Specialist to join our team! In this role, you'll help patients navigate eligibility programs, follow up on claims, and ensure timely payment resolutions with insurance companies and Medicaid agencies. RESPONSBILITIES: Follow up with insurance companies and Medicaid agencies on billed claims and submitted applications to ensure prompt status updates and payment resolution. Screen patients or their representatives to determine eligibility for third-party programs and assist with completing required documentation. Communicate proactively with patients, hospital staff, case managers, and government agencies to provide updates and resolve issues. Retrieve and review medical records, insurance details, and other supporting documentation as needed. Accurately document all activities in company systems while meeting quality, productivity, and compliance standards. Support overall program goals and perform additional duties as needed. MINIMUM REQUIREMENTS: High school diploma or GED required (equivalent education/work experience considered). Prior experience in healthcare coverage, eligibility, or revenue cycle management preferred. Knowledge of SSI/SSDI Knowledge of healthcare regulations (HIPAA, FMLA, Medicare, etc.). Proficient in Microsoft Office (Word, Excel, Outlook) and comfortable navigating multiple systems. Strong data entry and documentation skills with exceptional attention to detail. CORE COMPETENCIES: Excellent interpersonal, written, and verbal communication skills. Proven customer service experience in a fast-paced environment. Strong organizational, multitasking, and time management abilities. Able to work independently and collaboratively in a team setting. Handles confidential information with integrity and professionalism. Bilingual (Spanish/English) strongly preferred. WORK ENVIRONMENT & SCHEDULE: Office-based role with standard equipment (PC, phone, keyboard, etc.). Must be able to sit for extended periods; occasional lifting up to 25 lbs. Flexibility to work evenings or weekends as needed. WHY JOIN GETIXHEALTH?: Founded in 1992, GetixHealth is a trusted leader in healthcare revenue cycle management, serving clients across the U.S. and India. With more than 1,800 team members, we take pride in fostering a culture built on professionalism, innovation, and compassion. BENEFITS & INCENTIVES: Comprehensive Health Coverage: Medical, Dental, and Vision (eligibility after 60 days). Life & Disability Insurance: Basic, short-term, long-term, and voluntary options. 401(k) Plan: Eligible after 6 months of continuous service Paid Time Off (PTO): Accrue from day one + Paid Holidays Flexible Benefits: Customize your package to fit your personal and family needs. GetixHealth is an Equal Opportunity and E-Verify Employer. Note: This job description is not intended to be an exhaustive list of responsibilities or qualifications and may be subject to change based on business needs.

Schedule: Monday - Friday, 9:00 AM - 6:00 PM Pay: $19.00 - $20.00 hour (based on experience) + Quarterly Bonus Eligibility We're looking for a detail-oriented and motivated Eligibility Screener / Insurance Follow-Up Specialist to join our team! In this role, you'll help patients navigate eligibility programs, follow up on claims, and ensure timely payment resolutions with insurance companies and Medicaid agencies. RESPONSBILITIES: Follow up with insurance companies and Medicaid agencies on billed claims and submitted applications to ensure prompt status updates and payment resolution. Screen patients or their representatives to determine eligibility for third-party programs and assist with completing required documentation. Communicate proactively with patients, hospital staff, case managers, and government agencies to provide updates and resolve issues. Retrieve and review medical records, insurance details, and other supporting documentation as needed. Accurately document all activities in company systems while meeting quality, productivity, and compliance standards. Support overall program goals and perform additional duties as needed. MINIMUM REQUIREMENTS: High school diploma or GED required (equivalent education/work experience considered). Prior experience in healthcare coverage, eligibility, or revenue cycle management preferred. Knowledge of SSI/SSDI Knowledge of healthcare regulations (HIPAA, FMLA, Medicare, etc.). Proficient in Microsoft Office (Word, Excel, Outlook) and comfortable navigating multiple systems. Strong data entry and documentation skills with exceptional attention to detail. CORE COMPETENCIES: Excellent interpersonal, written, and verbal communication skills. Proven customer service experience in a fast-paced environment. Strong organizational, multitasking, and time management abilities. Able to work independently and collaboratively in a team setting. Handles confidential information with integrity and professionalism. Bilingual (Spanish/English) strongly preferred. WORK ENVIRONMENT & SCHEDULE: Office-based role with standard equipment (PC, phone, keyboard, etc.). Must be able to sit for extended periods; occasional lifting up to 25 lbs. Flexibility to work evenings or weekends as needed. WHY JOIN GETIXHEALTH?: Founded in 1992, GetixHealth is a trusted leader in healthcare revenue cycle management, serving clients across the U.S. and India. With more than 1,800 team members, we take pride in fostering a culture built on professionalism, innovation, and compassion. BENEFITS & INCENTIVES: Comprehensive Health Coverage: Medical, Dental, and Vision (eligibility after 60 days). Life & Disability Insurance: Basic, short-term, long-term, and voluntary options. 401(k) Plan: Eligible after 6 months of continuous service Paid Time Off (PTO): Accrue from day one + Paid Holidays Flexible Benefits: Customize your package to fit your personal and family needs. GetixHealth is an Equal Opportunity and E-Verify Employer. Note: This job description is not intended to be an exhaustive list of responsibilities or qualifications and may be subject to change based on business needs.

Headquartered in Atlanta, GA, EyeSouth Partners is an eye care physician services organization committed to partnering with leading physicians to build a premier network of eye care services in throughout the Southeast. EyeSouth's partner practices' clinical mission is to provide high quality medical and surgical specialty eye care. EyeSouth supports its affiliated practices and physician partners with capital, administrative resources, operating expertise, and strategic guidance with an absolute focus on clinical quality and a patient-first culture. EyeSouth's affiliate network consists of over 40 practices with 300+ doctors providing medical and surgical eye care services at over 175 clinic locations and 20+ ambulatory surgery centers throughout Georgia, Texas, Louisiana, Florida, Tennessee, Ohio, Kentucky, Alabama, Illinois, Pennsylvania, New York, North Carolina, and South Carolina. Position Summary The Benefits Verification Specialist will contact insurance companies, on behalf of the physician's office, to verify patient specific benefits. The Benefits Verification Specialist will ask appropriate questions regarding patient's benefits and complete data entry and/or appropriate forms to document patient's benefits coverage. Responsibilities Collects and reviews all patient insurance information needed to complete the benefit verification process for multiple entities. Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs. Verification process could include electronic validation of pharmacy coverage and medical eligibility. Identifies any restrictions and details on how to expedite patient access. Could include documenting and initiating prior authorization process, claims appeals, etc. Completes quality review of work as part of finalizing product. Reports any reimbursement trends/delays to supervisor. Performs related duties and special projects as assigned. Ability to work in a fast-paced office environment. Contributes to the team effort by completing other tasks/projects as needed. Qualifications Minimum of one year of healthcare facility, provider, or payer benefits verification experience or another related field or equivalent experience required Prior electronic medical records experience required (EMR/EHR) Must possess strong ethics and a high level of personal and professional integrity Intermediate computer skills including Microsoft Office (preferably Word and Excel) Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level. Self-motivated with strong organizational skills and superior attention to detail Work requires focus, flexibility, and the ability to adapt to changing work situations. Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams Company Benefits We offer a competitive benefits package to our employees: Medical Dental Vision 401k w/ Match HSA/FSA Telemedicine Generous PTO Package We also offer the following benefits for FREE: Employee Discounts and Perks Employee Assistance Program Group Life/AD&D Short Term Disability Insurance Long Term Disability Insurance EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Verifies benefits coverage and serves as an intermediary with third-party payers Assists patient by answering questions about their coverage Shift: Day Hours: 8 a.m. - 5 p.m Required Skills: High school graduate or GED Prior medical office experience preferred Medical terminology is preferred. Computer proficiency with MS Word and Excel Medical Insurance experience preferred

Job Description At Farmers Insurance, we provide a wide range of coverage options tailored to our client's needs. We are currently seeking an Insurance Agency Producer to step into the role of Life Specialist and join our San Antonio team. In this unique role, you'll work with a tenured team that has been serving the community for over 8 years. As a Life Specialist, you'll focus on helping families protect their futures, build long-term client relationships, and make a meaningful impact - all while enjoying the tools, resources and support of a leading organization. Benefits Annual Base Salary + Commission + Bonus Opportunities Paid Time Off (PTO) Dental Insurance Vision Insurance Life Insurance Disability Insurance Hands on Training Mon-Fri Schedule Career Growth Opportunities Cancer Insurance Responsibilities Prospect and generate leads through multiple channels including working existing books of business, cold calling, networking, referrals, and digital marketing. Build and maintain strong relationships with clients to understand their unique life insurance needs and provide tailored solutions. Conduct needs-based assessments and confidently present life insurance options. Guide clients through the application process, ensuring a seamless and timely experience. Stay current on product knowledge, industry trends, and competitor offerings. Provide outstanding customer service with proactive follow-ups to ensure client satisfaction and policy renewals. Requirements Strong communication and interpersonal skills with a customer-first mindset. Self-motivated with a drive to meet and exceed sales goals. Ability to build trust and establish long-term client relationships. Previous experience in Life insurance sales, or financial services preferred (but not required). Active Life & Health Insurance License (or willingness to obtain). Active Property & Casualty Insurance License (or willingness to obtain).

Full Time 12238 Silicon Drive Clerical Day Shift $18.75 - $24.25 /RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children's Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE High school diploma or GED equivalent is required. Two or more years of experience in claim processing and/or billing experience required. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred. Knowledge of ICD-9, CPT 4 coding and medical terminology is required.

Hi! I am a professional senior healthcare recruiting consultant placing healthcare professionals permanently in the United States. I am currently hiring for Claims & Denials Coordinators in the San Antonio area.This is for a Fortune 125 company. We have 5 Claims & Denials Coordinators positions available. I'm looking to hold my final batch of phone screenings tomorrow so apply now and please send your update resume directly. Position is Long Term Temp up to 6 months (after that position may end, get extended or go permanent based on business need), Schedule is Mon-Fri, 8:00am-5:00pm, some OT may be required. Will be working in office. Competitive pay and amazing benefits! Thanks, Ron Payos 321-332-6801 Job Description In charge of generating denial letters to explain to providers why services were not approved. Qualifications High school diploma or equivalent 2+ years of managed care experience (either working at a plan or interacting with a plan) Knowledge of medical terminology Knowledge of claims, appeals, & denials Computer skills Administrative experience Additional Information All your information will be kept confidential according to EEO guidelines.

About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward's team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average. Job Description Update and maintain various systems/tools per standard process documentation which may include: Execute transactions Without minimal direction, enter data and retrieve information from group specific system (all new hires might require some direction initially) Audit own data entry for accuracy and make required corrections Conduct data verification Respond to various requests for information, as needed. Escalate to supervisor as appropriate File, archive and retrieve documents (paper-based and electronic) using filing standards Produce standard correspondence by following existing templates. Adhere to client formatting and quality standards. Proof and edit work for syntax, grammar and punctuation Respond to information requests by searching, summarizing research results and compiling in requested format May coordinate the work of a small team in areas of high volume transaction processing and/or the training/education of new and/or more junior tea Experience in Siebel or Cyborg is a plus but not required. Minimum 2 years of corporate payroll experience - 2 years of experience in analysis and solving of complex problems - 2 years of experience in client facing environment - Minimum of 1 year operational project support Preferred Qualifications: - 2 years of experience in corporate payroll tax. - FPC/ CPP certification - Bachelor͛s degree Conversion after 6 mths possible based on performance. Thanks , Asma Khan Suri Additional Information Must be able to pass a background and drug screen

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.