4 claims analyst ii jobs found in Dallas

Overview The Medical Bill Review Support Analyst supports the Medical Management department's key goals of enhancing cost containment. Provides strategic and technical bill review to assist claim offices and adjusters. Accomplishes Managed Care objectives by working processes; planning and evaluating adjuster activities and Medical bill review activities.  Technical abilities and industry-specific knowledge to review Workers Compensation medical bills.   *This role is hybrid out of our Dallas, TX office* Responsibilities Plan, execute, and oversee bill audits related to state fee disputes. Assist in the development of fee dispute processes, including overall management and monitoring programs. Perform fee dispute reviews and submit relevant formwork related to re-pricing and network vendors. Review and audit bills to verify correct billing practices and contractual rates. Ongoing development of cost...

The Vice President of Claims will execute on the strategic goals and vision of the company. This includes the management and Development of staff and revenue. This role requires a high level of analytical, interpersonal, and organizational skills and will be responsible for claims quality, customer satisfaction and retention.  The VP of Claims  will also identify, facilitate and participate in essential strategic projects  for operational improvement as well as support and directly participate in sales presentations/RFP responses and the development of opportunities to  promote  the company’s overall growth.  This is a hybrid position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Position shares responsibility for meeting and exceeding market profit and revenue goals annually Position shares responsibility to grow market share through accountability for customer satisfaction and retention Participates in Marketing and Sales presentations of prospective...

The Indemnity Claims Adjuster  manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a hybrid position and candidate must reside in Texas. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This position is onsite in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic...