17 supervisor claims jobs found in Fort Worth

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 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 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 Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider appeals. 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 appeals. 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: Supervises all daily activities of payment integrity team related to quality assurance and provider appeals Ability to assist team with problem-solving, payer policy and clinical questions regarding audits performed by CERIS Ability to...

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 position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: The incumbent is responsible for investigating, evaluating, negotiating, and resolving personal lines property claims. Responsible for adjusting major and complex losses in their entirety, but may also adjust standard losses. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not...

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 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...

Why GM Financial? GM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America and the Asia Pacific region. Through our long-standing relationships with auto dealers, we offer attractive retail financing and lease programs to meet the needs of each customer. We also offer commercial lending products to dealers to help them finance and grow their businesses.   At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity and creates a sense of community and belonging. Here we do more than work — we thrive.   Our Purpose: We pioneer the innovations that move and connect people to what matters    About the role: GM Financial is targeting significant growth as it transforms the Protection/Insurance Products into a full captive platform. Our team is responsible...

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...

The Correspondence Department 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 hybrid position reporting to Fort Worth, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:  Ensure timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers Responsible for directing a designated group of employees in their day-to-day operations Responsible for monitoring quality control of results per employee as well as the entire unit overall Responsible for ensuring Metrics are in compliance daily Responsible for tracking and reporting of department metrics to Director...

The Implementation Manager will be responsible for enhancement to existing products and development of new products to broaden current service offerings. This role will also be accountable for project management and implementation management with new and existing clients.  The primary purpose of the role is to work closely with the assigned Account Manager, Implementation Coordinators, IT, and Operations to complete the implementation of client programs and to facilitate the transition to field operations and account management personnel for ongoing servicing.   We offer a competitive salary and benefits package. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Participates in oral presentations Prepares and manages implementation plan from prospect presentation through conclusion Identifies required resources Develops and prepares information necessary for setup of customer across all CorVel systems Coordinates all internal meetings on a...

The Document Processing Department 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 hybrid role reporting to Fort Worth, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:  Ensure timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers Responsible for directing a designated group of employees in their day-to-day operations Responsible for monitoring quality control of results per employee as well as the entire unit overall Responsible for ensuring Metrics are in compliance daily Responsible for tracking and reporting of department metrics to Director of Operations...

Position Summary:   The Senior Vice President of Production Development acts as a strategic partner to high profile clients and works directly with the CEO and Managing Directors to aid in growing and maintaining their books of business. The Senior Vice President of Production Development drives accountability for execution of account strategies through the delegation of tasks and empowering account managers and other service team members. Supervisory Responsibilities:   None Essential Tasks: Responsibilities related to Existing Accounts Help gather exposure updates and applications for renewals Track and ensure service timeline items are completed Manage daily task tracker of ongoing follow up items Verify renewals are booked and items issued (COI, auto ID cards, etc.) Track claims submitted to the claims department and aid with quality control Aid in marketing strategy for renewals Help evaluate incumbent and alternative markets Track account details:...

CERiS in Fort Worth, Texas is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related Groups (DRG) QC Clinical Auditor will be responsible for performing quality control DRG validation (clinical/coding) reviews of internal audit team reviews of medical records and/or other documentation to determine correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract for which review services are being provided. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination, as well as communicating missed or incorrect information to the auditors in a professional manner. Experience using, ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. This is a remote position. Job Duties and Responsibilities: The Quality Control...

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...

The Senior 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 hybrid role reporting to Fort Worth, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:  Ensure timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers Responsible for directing a designated group of employees in their day-to-day operations Responsible for monitoring quality control of results per employee as well as the entire unit overall Responsible for ensuring Metrics are in compliance daily Responsible for tracking and reporting of department metrics to Director of...