31 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 Closing Team Lead is responsible for monitoring and tracking all closing processes. This role runs queries, maintains reports, and supports the trainers while keeping up with the training material. The Closing Team Lead may assist supervisors with additional projects/tasks. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Run queries to collate data; maintain reports and Excel spreadsheets as needed Monitor and track completion of files and special tasks Oversee the training for all new Closing Analysts Responsible for keeping training material up to date Assist Team of Closing Analysts with questions and escalations Required to close files when needed Serve as a final Quality Control for Closing Analyst files as needed Track analyst errors and create coaching measures Lead meetings and conduct presentations as needed Additional duties as assigned   KNOWLEDGE & SKILLS:...

The CERIS Operations Supervisor is responsible for managing daily production for the department, which may include one or more of the following functions:  human resources, customer service, and promoting positive mentorship for the team. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for directing a designated group of employees in their day-to-day operations Accountable for maintaining highest quality of service Handle human resources matters directly related to employees supervised Maintain employee confidence and protect operations by keeping sensitive information confidential May be required to travel overnight to attend meetings May perform daily, weekly and monthly reviews of various reports, invoices, logs and expenses Approve Electronic time cards for employees Assist Manager in establishing employee schedules  Oversee quality control and tracking or error rates Maintaining HIPAA compliance in all aspects of...

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...

The Correspondence Team Lead is responsible for monitoring and tracking all processes pertaining to the Correspondence Team. The Team Lead runs   queries   and maintains reports, as well as trains new employees and keeps up with the correspondence training material. This role may assist the supervisor with additional projects/tasks. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES:  Creates   and   maintains reports in worksheets and formulas in Excel Runs   queries to collate data Merges documents from different operating sources, utilizing Microsoft Word Mail Merge Compiles specific supporting documents to send with correspondence Monitors and tracks completion of all processes Responsible for training all new analysts Responsible for keeping training material up to date Tracks analyst errors and creates   coaching   measures Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of HIPAA regulations...

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...

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,...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for a Senior Commercial Lines Account Manager in our Fort Worth, TX office. Position Summary:  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, suspense items,...

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...