10 claims technician jobs found in Fort Worth, TX

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 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...

Are You Driven?® We Are. We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success.  We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make daily. At GAINSCO, it is our people that set us apart. If you are looking for a place where you can make a difference, perceive how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you. Why Join GAINSCO? GAINSCO’s work environment rewards engaged individuals who have a desire to contribute and succeed. That’s because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a Champion with GAINSCO. We are currently seeking a skilled and experienced Auto Damage Appraiser to join our team. In this role, you will be responsible for completing auto physical damage appraisals with...

Why GM Financial Technology? Innovation isn’t just a talking point at GM Financial, it’s how we operate. From generative AI and cloud-native technologies to peer-led learning and hackathons, our tech teams are building real solutions that make a difference. We’re committed to AI-powered transformation, using advanced machine learning and automation to help us reimagine customer interactions and modernize operations, positioning GM Financial as a leader in digital innovation within a dynamic industry. Join us and discover a workplace where your ideas matter, your development is prioritized, and you can truly make a global impact. About the role: The Digital Data Engineering Manager will lead a team responsible for building and maintaining marketing data infrastructure and tag management platforms. This role defines and executes the multi-year strategy for data capture, storage, and access. The manager oversees the design and management of data pipelines for ingestion,...

Company: Marsh McLennan Agency Description: JOB TITLE: Private Client Account Executive JOB TYPE: FLSA Exempt ESSENTIAL DUTIES & RESPONSIBILITIES: DOCUMENTATION Process documents necessary to maintain the Client Insurance Program, utilizing agency management system.  These duties include but are not limited to:       Act as the primary contact with the Producer and/or Client. New Business placement and cross selling is conducted as needed to maintain client’s insurance program. Initiate correspondence with the marketplace. Function as the primary contact with all companies to ensure proper processing of all requests necessary to effectively maintain the client’s insurance program. Maintain positive client relationships and have the ability to analyze situations, make proactive decisions and follow through. Prepare and obtain pre renewal updates for all clients. Create Acord applications, including Supplementals, as needed, for submissions to...

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:...

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...

Position Summary:   The Commercial Lines Account Executives have leadership/mentorship and advisement responsibilities over Account Managers and their respective books of business/client groups to include gathering information from clients, servicing clients, and setting expectations of timeline for completion of work tasks. 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, suspense items, etc.), Account Managers, and Client Service Managers Investigates, initiates and prepares necessary summaries of insurance, proposals and...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...

The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Take inbound calls and makes outbound calls as needed. Analyzes client and provider inquiries to determine appropriate steps for resolution. Performs review of claim history to ensure accurate information is communicated to internal and external customer. Works directly with internal departments and management for resolution of Customer Service inquiries. Able to accurately communicate CERIS findings to clients and providers in written and verbal format. Maintain reports and spreadsheets as needed. Additional duties as assigned.   KNOWLEDGE & SKILLS:  Excellent communication, verbal, written and organizational skills. Prior knowledge of...