27 senior insurance employee benefits analyst jobs found in Fort Worth

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work independently...

The IT Compliance Analyst supports the organization’s compliance and risk management programs by coordinating assessments, audits, and certifications across frameworks such as HITRUST, SOC, HIPAA, and NIST. This role helps maintain a strong IT compliance posture by managing evidence, monitoring control performance, maintaining documentation, and partnering closely with IT, Security, Privacy, Legal and external auditors. The Analyst also contributes to continuous improvement efforts, compliance automation initiatives, and reporting that supports leadership visibility and informed decision-making.   Key Responsibilities Assessment & Audit Support Coordinate internal and external compliance assessments, audits and certifications. Prepare, organize, and manage evidence to meet control and audit requirements. Track remediation activities and ensure timely closure of identified gaps. Maintain audit-ready documentation and support readiness reviews. Additional...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Punctual and consistent attendance required Additional duties as...

Higginbotham, a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for an Data & Reporting Coordinator for our Fort Worth, TX office. Position Summary : Help drive business insights by supporting key performance tracking and reporting needs. This role focuses on tracking producer goals, assisting with revenue variance analysis, evaluating block efficiency for account managers, fulfilling report requests, and running data audits to ensure accuracy and completeness. Essential Tasks: · Track and maintain performance metrics, including producer goals and block efficiency for account managers by preparing reports and identifying patterns in workload distribution. · Support office revenue variance analysis by compiling, reviewing, and organizing data to identify discrepancies or trends. · Fulfill internal report requests by extracting and formatting data from the agency management system,...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collect supporting data and analyze information to make decisions regarding accuracy of billing Appropriately document work and final conclusions in designated computer program Understanding of Surgical Implants Understanding of CERiS systems and Data Base informatics Capability to meet department expectations and standards Be a team player working with Leadership Team(s) within a positive team environment Additional duties/responsibilities as assigned Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as maintain HIPAA compliance   KNOWLEDGE & SKILLS: Exceptional organizational, strategic and critical...

The Commercial Lines Account Manager - Select Business 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. 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 necessary proposals, summaries...

Description Senior Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils. Training is a critical component to your success and that success starts with reliable attendance.  Attendance and active engagement during training is mandatory Responsibilities: Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss losses. Reviews and utilizes financial statements to adjust complex business interruption losses. Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure. Engages and manages consultants as required...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for a Sr . Employee Benefits Account Coordinator  for our North Texas   office. The  Employee Benefits Account Coordinator provides administrative support to internal account managers and maintains a professional relationship with our external clients. This role will support the worksite clients only. Essential Tasks: Conducts data entry into Excel spreadsheets, internal agency management system, carrier websites, House Bill requests Assists in marketing of accounts as directed by account managers Assists with the preparation of reports, proposals and other presentation materials Audits billing statements for accuracy on behalf of clients Generates open enrollment materials such as enrollment guides, election forms, personalized confirmation sheets, enrollment/change forms, etc. Assists in processing necessary...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for an Employee Benefits Strategic Account Executive for our Fort Worth, TX office.  The  Employee Benefits Strategic Account Executive  serves as the strategic leader or member of the client management team for the most complex benefit accounts, and is responsible for client satisfaction, strategic planning, and quality assurance. Position Summary: The Account Executive serves as the strategic leader or member of the client management team for the most complex benefit accounts and is responsible for client satisfaction, strategic planning, and quality assurance. Essential Tasks: Manage a complex book of business comprised of clients with various funding methods, advanced contract features and structures that require a higher level of expertise. Provide strong insurance technical expertise to clients and members...

Position Summary:   The Senior Legal Counsel serves as a senior member of the Legal and Compliance team, providing strategic legal advice, managing significant legal risks and supporting the General Counsel in overseeing the department's operations. This role involves high-level counsel to executive leadership and cross-functional stakeholders on a wide range of corporate, commercial, compliance and risk-related issues to advance business objectives while protecting the organization. Essential Tasks: Corporate Governance: Coordinate meetings of directors/managers of various business units, including scheduling, preparing agendas and related materials and maintaining records of meetings. Provide guidance on board-related matters, including the development and composition of committees, as appropriate.  In conjunction with the General Counsel, formulate and memorialize required agreements and procedures related to intercompany transactions. Contract Drafting, Review, and...

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...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for a  Commercial Insurance Account Manager for our Fort Worth, TX  office. 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. Essential Tasks: Collectively or independently 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 Provides technical support to Producers (coverage-wise, with proposal,...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collects supporting data and analyzes information to make decisions regarding accuracy of billing Appropriately documents work and final conclusions in designated computer program Understanding of Surgical Implants Meets department's expectations and standards  Additional duties as assigned   KNOWLEDGE & SKILLS: Understanding of Itemization Review for designated clients Understanding of CERIS systems and Data Base informatics Understanding of HIPAA regulations Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment...

Position Summary: The Sr. Claims Operations Specialist is responsible for driving operational excellence within the claims function. This role focuses on improving efficiency, streamlining workflows, and optimizing processes within the insurance broker Claims Advocacy Service Model. The position works closely with the Claims Leadership Team to support strategic initiatives, provide operational insights, and implement scalable solutions that enhance productivity and effectiveness. Supervisory Responsibilities:   None Essential Tasks: Analyze existing claims operations workflows to identify inefficiencies, gaps, and areas for improvement to enhance the Claims Advocacy Service Model. Develop, implement, and monitor process enhancements to optimize claim intake, review, and tracking. Collaborate closely with the Claims Leadership Team to align operational initiatives with business goals and strategic priorities. Partner with IT, analytics, and business teams to...

Position Summary: The General Agency Services Specialist is a cross-functional role responsible for delivering high-quality, consistent support throughout the group benefits client lifecycle. This position is designed to be flexible, with team members trained across quoting, onboarding, implementation, renewals, and ongoing service. The role supports producers, clients, and internal teams to ensure an efficient, accurate, and seamless experience that aligns with General Agency workflows and expectations. This would be an in-office role  that can be based in our Fort Worth, Austin, or Houston, TX offices). Essential Tasks: Prepare and deliver group benefit quotes, including medical and ancillary lines of coverage Analyze plan designs and rate proposals to support producer strategy and client needs Collaborate with producers and account teams to ensure quote requests are clear, accurate, and timely Maintain effective communication with external quoting partners or...

Position Summary:   The Account Manager position maintains a professional relationship with our clients through exceptional customer service.  Account Managers are assigned a book of business comprised of fully insured and level funded clients in our Small Business Unit. This role is responsible for obtaining clients’ trust by meeting their needs and expectations. They are also responsible for supporting our sales Agent(s) in producing new business and renewing existing business.  Account Managers serve as an advocate to our clients and their employees through positive relationships with the various carriers and continuous education. Supervisory Responsibilities:   None Essential Tasks: Acts as the primary contact between client, prospect, agency, and producer; represents the agency in handling complaints, arbitrating disputes, or resolving grievances Handles or refers all service requests by our clients Initiates and handles marketing of accounts beginning 120 days...

  Position Summary:   The Manager of New Partner & EB Operations is responsible for overseeing and supervising the coordination and optimization of the Employee Benefits Operations Team.   Supervisory Responsibilities:   Manage Operations team, including conducting performance reviews, providing mentoring and coaching to ensure team growth. Essential Tasks: . Oversee Carrier Management functions, including but not limited to Producer Appointments, Carrier on-site visits and presentations, online carrier portal access, and the Panel Carrier Program. Collaborate with carriers, new partners and internal team members to consolidate current New Partner contracts under Higginbotham's tax ID/producer numbers, ensuring that the New Partner's book of business is accurately reflected in supplemental compensation calculations. Support New Partner integration by maintaining the New Partner Project Plan using project management tools as necessary and supervise the...

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...

Position Summary: The Project Manager will oversee and manage high-impact projects from inception to completion, ensuring they meet organizational goals, are delivered on time, within scope, and on budget. The ideal candidate will possess extensive experience in marketing and communications project management, demonstrate strong technology and organizational capabilities, and have a proven track record of managing complex, fast-paced projects. Supervisory Responsibilities: Project related only . Key Responsibilities: Project Planning: Develop detailed project plans, including scope, objectives, deliverables, timelines, and resource requirements. Coordinate and lead project activities, ensuring milestones and deliverables are met. Identify project risks and develop mitigation strategies. Stakeholder Management: Act as the point of contact for project stakeholders. Communicate project goals, progress, and changes effectively to ensure alignment and manage...