33 healthcare jobs found in Fort Worth

Position Summary:   The Commercial Lines Account Manager   provides prompt, accurate and courteous service to our clients, producers and company personnel, while offering a high level of support in obtaining, maintaining, expanding and servicing our commercial accounts. Supervisory Responsibilities:   None Essential Tasks: Collectively plans, designs and implements appropriate insurance programs for clients that coincide with agency guidelines Maintains knowledge of new developments or changes with various carriers and new Federal/State laws that may affect how our clients conduct business; consults, informs and educates clients about coverage, exclusions and exposures: documents electronic filing accordingly Generating premium allocations for clients; advanced Microsoft Excel proficiency Negotiating rate terms and conditions with Carriers on behalf of clients Provides technical support to Producers (coverage-wise, with proposal, suspense items, etc.) Prepares...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description Job Description Inside Property Adjuster - Trainee - Hybrid – DFW, TX A day in the life of an inside Property Adjuster, and what it takes to do the job!   As a Moderate Inside Property Adjuster, you will provide exceptional service to our policyholders. Working in this hybrid environment, your primary responsibility will involve virtually inspecting damages, investigating coverage, preparing estimates, and settling claims promptly and accurately. You will be interacting with customers, contractors, and vendors...

The Hospital Bill Audit Manager is responsible for planning, leading, and coordinating multiple teams of nurse auditors and associated billing staff in a fast paced, productivity-based environment. This role oversees auditors performing varying types of medical bill audits including, but not limited to, medical record audits, hospice, implant, and outpatient or ancillary facility claims. This team also performs onsite and remote hospital bill audits. Must be willing to travel for onsite facility audits and other meetings as needed.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Utilize nursing education, experience, and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate results Assist the Hospital Bill Supervisor in the training, professional development, and retention for the nurse auditors Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other...

The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify and resolve quality issues within repricing processes Develop and implement QA policies and procedures Monitor compliance with pricing guidelines and contractual requirements Investigate repricing discrepancies and apply corrective actions Prepare QA reports and documentation Collaborate with stakeholders to align quality objectives Provide training and guidance on repricing standards Conduct risk assessments to mitigate potential errors Maintain confidentiality of client data, PHI, and PII Additional duties as assigned...

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. Experienced Auto Damage Adjuster- Fort Worth, TX Salary: $32.05-$40.70 per hour/$64,575-$82,000 Sign on bonus: $1,500 for candidates who hold  an adjusters license that is active and in good standing. We are looking for talented Auto Damage Adjusters to join our team in Fort Worth, Weatherford, Mineral Wells TX. As an experienced Adjuster, you should have a minimum of 12 months of...

The Recovery Supervisor is responsible for analysis and monitoring of claims audit data across multiple platforms. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and claims processing. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.     This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Manage team performance by setting and communicating standards and deadlines, measuring results, and providing feedback. Maintain positive morale by leading the team through example and accountability with a focus on helping each member achieve their best performance...

The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receiving and analyzing appeal documentation to determine appropriate actions Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards Utilize applicable tools and resources to complete setup Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Medicare, Medicaid, and commercial insurance guidelines...

The Procurement Trainer is responsible for educating new and existing staff on Procurement procedures and client-specific protocols. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for Training of New Staff in the Following Areas: New hire orientation, including company and departmental policies Setup and proper use of communication tools  MedCheck Select system Specific client systems used in the Procurement process Pre-/Post-Training Responsibilities: Maintain all training guides Remain available to teams for questions Update the manager and/or supervisor on all trainees’ progress Conduct periodic refresher classes as needed General Procurement Support: Assist Support Team with quality control, distribution, email, and documenting procedures Assist co-workers, supervisor, or management to accomplish product goals and identify any potential issues in a proactive manner Maintain HIPAA compliance...

The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity.  Ensures timely application of QC protocols to meet production standards. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Analyses itemization line item descriptors from hospital billing entered Verifies line item data sets for completeness, correctness and understandability Maintain the integrity of each provider chargemaster within Scheck Maintains consistent communications with the Data Entry Analyst on line item entries Maintains constant communications with the Medical Review Department regarding unusual billing practices and discovery of potential errors Maintain 100% accuracy of data set(s) PRIOR to moving files to the next department to meet production and turnaround time requirements Maintain HIPAA compliance in all aspects of communications Comply with all safety rules and regulations during work hours in conjunction with...

The CERIS Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This role is responsible for making claim-related recommendations and communicating status of the claim to involved stakeholders.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations and communicates claim status to referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Maintain HIPAA compliance Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practices Strong organizational skills Ability to meet or...

The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement made to healthcare providers. Responsibilities include identifying payment variances and working internally and externally to resolve such issues. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Analyze and adjust/reprice claims to ensure accurate reimbursement rates in accordance with contractual agreements and payer guidelines Establishing and maintaining accurate pricing structures and rules to ensure competitive and profitable pricing strategies across various claims  with precision Identifies errors in reconciliation files across multiple work streams and business units for multiple sites and with external partners. Performs contract and reimbursement variance analysis. Analyzes claims data to identify...

The CERIS Operations Manager is responsible for overseeing all aspects of the department including Personnel Hiring, Quality Assurance of Product, Workflow, Maintaining the tracking of and accountability of staff regarding production standards and department expectations. Works collaboratively with other department managers to achieve departmental requirements and goals.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:  Ensures timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers Directs a designated group of employees in their day-to-day operations Monitors employee and unit quality control Ensures daily compliance with metrics Tracking and reporting of department metrics to Director of Operations on a monthly basis or as required Handles scheduling and monitoring of staff’s attendance Ensures timely distribution of...

The Setup Team Lead is responsible for assisting and supporting   the Setup Supervisor with ensuring   the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

The Procurement Coordinator is responsible for maintaining a consistent workflow by distributing claims to Procurement Analysts. This role keeps track of current volume on an individual basis to ensure even distribution throughout the department. The Procurement Coordinator is a detail-oriented contributor performing   Quality Control (QC) reviews for incoming and outgoing files. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: File distribution to all Procurement staff (initial distribution and redistribution as necessary) QC/Review of incoming and outgoing files  for accuracy before distribution to end users Generate   and   send   mail, e-mail, reports, and forms to inter-office personnel; may as needed send reports to clients, managers, and other CorVel offices Document procedures and all client-specific protocols Additional duties as assigned   KNOWLEDGE & SKILLS: Proficient in Microsoft Office...

The CERIS Implementation Director is responsible for providing strategic leadership and oversight for the implementation of new and existing client programs, product enhancements, and service expansions. This role ensures the successful execution of complex implementations while aligning implementation strategy with organizational objectives, operational readiness, and long‑term client success. The CERIS Implementation Director works closely with executive leadership, Account Management, Implementation Managers and Coordinators, IT, Operations, Product, and Sales to ensure consistent, high‑quality delivery and a seamless transition to ongoing account management and field operations. This role is also accountable for leading and developing the Implementation team and continuously improving implementation processes across the organization. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides overall leadership and accountability for the...

As a Project Manager (PM) you will be the project lead on CERIS Operations IT and AI focused projects. This role will work under the CERIS Operations department and build cross functional relationships with the IT/Engineering, Account Management, and Operations teams. This is a hybrid position that will require onsite attendance Tuesdays and Thursdays. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Lead IT and AI Focused operations projects to ensure that we have clearly defined requirements, and solid development, implementation testing and deployment plans Own and deliver successful outcomes that align with the expectations defined in our project requirement documents Be a cultural ambassador, fostering teamwork, collaboration and overall cross functional alignment across all teams Ability to quickly understand, document and track business technology requirements  Support the review of IT intake forms while asking clarifying questions to ensure projects are...

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through verification of coding and...

The Baldwin Group is a dedicated team of professionals who specialize in business insurance, employee benefits, retirement planning, and personal insurance.   We've   grown from a small local company in 2011 to a major national firm with a wide range of   expertise , serving two million customers across the United States.       The Baldwin Group Personal and Health Insurance works with healthcare companies, medical providers, and community organizations.   We're   known as one of the top Field Marketing Organizations (FMO's) in our industry. The Group ranks as one of the top 20 insurance brokers in the United States.     Job Description Summary:   Seeking   driven, self-motivated, energetic talent to join our team! If you are considering a career move, or already a licensed agent seeking change, then look no further! With ACA Open Enrollment rapidly approaching now is the time to elevate your career with an opportunity...

The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring the team meets protocol, as well as performing supervisory duties during the supervisor's absence. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor/Audit and reports for Procurement and clients Monitor/Audit files in Procurement staffs individual service queues via Management Console Tool for accuracy and timely claim processing Assist with Procurement QC queue tickets during high volume times Assist team members with all questions and concerns Answer emails and phone calls from both Procurement and other internal departments and also externally from Clients/Providers regarding any claims processing concerns Additional duties as assigned   KNOWLEDGE & SKILLS: Exceptional organizational skills Ability to work independently and in a team environment Ability to work in a fast paced/production...

The Baldwin Group is a dedicated team of professionals who specialize in business insurance, employee benefits, retirement planning, and personal insurance.   We've   grown from a small local company in 2011 to a major national firm with a wide range of   expertise , serving two million customers across the United States.       The Baldwin Group Personal and Health Insurance works with healthcare companies, medical providers, and community organizations.   We're   known as one of the top Field Marketing Organizations (FMO's) in our industry. The Group ranks as one of the top 20 insurance brokers in the United States.             The A dvisor   will   be responsible for   assisting   senior a dvisors   with   a Book of Business (BOB) which includes assisting with current customers/clients with selecting plans, enrolling in plans, customer service inquiries,   general questions /concerns, and...