47 up to jobs found in Fort Worth, TX

Position Summary:      The Benefits Analyst is responsible for interpreting Summaries of Benefits and Coverage (SBCs) and any client-specific benefit information provided to accurately complete the department’s Project Requirements Document (PRD), and benefit book templates.  Key Responsibilities:   Work with the Project Manager to understand the changes needed or the collateral to be created for the client.   Obtain all necessary background information and materials and ask relevant questions to enable project completion.   Effectively interpret SBCs, SPDs, benefits summaries and marketing spreadsheets and ensure the information is accurately transferred to or annotated in the PRD and other benefit templates.    Review all work for consistency, accuracy, and wholeness.   Ensure edits consistently follow our Higginbotham standard for benefits information.    Promptly inform Project Manager and Content Writer when...

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...

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: Supports a team by identifying, soliciting, and arranging appropriate insurance coverage for clients by accessing binding authority and brokerage markets. Responsibilities include but not limited to underwriting new and renewal business, ensuring adherence to binding authority carrier guidelines, approving policy changes, maintaining workload, solving coverage issues, monitoring claims and managing...

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...

Sign-On Bonus Opportunity of up to $1,000* Pay Range: $18 - $22 / hour Our Perks: Unlimited/Uncapped commission Lucrative incentive sales plans, bonuses and sales contests No Cold Calling- We have a high volume of inbound sales leads and walk in traffic Comprehensive paid training and licensing with continuous on-going training and mentorship Recognition culture Comprehensive Benefits package including medical, dental, vision and life insurance Retirement Plan: A 401K plan with a percentage of company-matched contributions Fitness: Discount gym membership to over 12,200 fitness centers and 9,300 on-demand workout videos including a $15 a month reimbursement. Employee Assistance Program: Confidential assistance to you or anyone in your household who is experiencing personal or professional problems — at no cost Mental Health Benefit: 12 therapy sessions and 13 additional psychiatric sessions. Extra Perks: Access to disability, hospital...

Sign-On Bonus Opportunity of up to $1,000* Pay Range: $18 - $22 / hour Our Perks: Unlimited/Uncapped commission Lucrative incentive sales plans, bonuses and sales contests No Cold Calling- We have a high volume of inbound sales leads and walk in traffic Comprehensive paid training and licensing with continuous on-going training and mentorship Recognition culture Comprehensive Benefits package including medical, dental, vision and life insurance Retirement Plan: A 401K plan with a percentage of company-matched contributions Fitness: Discount gym membership to over 12,200 fitness centers and 9,300 on-demand workout videos including a $15 a month reimbursement. Employee Assistance Program: Confidential assistance to you or anyone in your household who is experiencing personal or professional problems — at no cost Mental Health Benefit: 12 therapy sessions and 13 additional psychiatric sessions. Extra Perks: Access to disability, hospital...

Why Join GEICO? 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 on relentless innovation to exceed our customers' expectations while making a real impact on local communities nationwide.   Founded in 1936, GEICO is a member of the Berkshire Hathaway family of companies and one of the largest auto insurers in the United States. 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. Please note: This is not a remote role; you will be required to work in the territory listed on the job posting.   Your Impact at GEICO            As a Field   Auto Damage Trainee,   you’ll...

The Training Specialist is responsible for developing the knowledge and presentations skills of CERIS Operations department staff trainers. This role ensures that CERIS is equipped with an Operations workforce that can optimize its current and future goals and objectives, and deliver quality services that can meet our clients’ requirements and service expectations. In order to efficiently execute his/her daily responsibilities, the Training Specialist must first possess a deep understanding of the business to articulate what CERIS does and to clearly demonstrate all aspects of the Operations roles in order to be able to successfully train and oversee the department trainers.   Other duties to be carried out by Training Specialist will include conducting classroom, virtual, and field training to internal employees/colleagues, developing training materials as needed, monitoring new hires, and performing other tasks as required by the Training Manager. This is a hybrid...

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.   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 Itemization Review Supervisor will maintain a positive team building approach with emphasis on reporting, leadership and professional communication with all CERIS departments.    This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Maintain accurate, current data and analytics to support informed decision-making and reliable outcomes Manage and track client appeals as required Oversee the file assignment process and continuously monitor nurse workloads and queues Ensure daily prioritization of all claims is clearly understood and executed Prepare and maintain monthly metrics and reporting Demonstrate working knowledge of CERIS systems and databases Lead and support the team with minimal managerial oversight Foster a collaborative and positive work environment through effective team leadership Ensure strict adherence to HIPAA compliance standards Additional duties as assigned   KNOWLEDGE & SKILLS: Comprehensive...

The Itemization Review Coordinator is responsible for maintaining a consistent workflow by distributing claims to Quality Control and Itemization Review Nurses. Keep track of current volume on an individual basis to ensure even distribution throughout department. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor incoming and existing claims and distribute to staff based on priority and due date Maintain and update departmental spreadsheets and attendance calendar per supervisor request Ensure an even and fair distribution of claims to staff Notify staff of priority claim assignments Notify supervisor(s) of claims requiring/receiving extensions Notify supervisor(s)/management of back log files, late files, low census, and waiting list Update SharePoint website as required Assist supervisor(s)/management to identify potential issues in a pro-active manner Maintaining/updating/assisting with all New Hire documentation/packets...

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  Identify errors in reconciliation files across multiple work streams and business units for multiple sites and with external partners Perform contract and reimbursement variance analysis Analyze claims data to identify contractual overpayments and billing...

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 role. 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...

The CERIS Policy & Payment Integrity Coordinator (PPI Coordinator) plays a key role in supporting the Policy and Payment Integrity teams by managing workflow, ensuring timely assignment of appeals, and maintaining accurate tracking systems. This position requires strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Manage and monitor general PPI department mailboxes to ensure timely review and routing of incoming correspondence Assign appeals to appropriate team members based on established workflows and production needs Maintain and update appeal trackers to ensure accurate and current data is available for reporting and performance monitoring Track the status of assigned appeals to support timely completion and compliance with internal expectations and external deadlines Identify workflow delays or discrepancies in...

The Payment Integrity Analyst (Team Lead) assists with leading the Policy and Payment Integrity (PPI) team while maintaining the regular duties and responsibilities of this role which is accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. The Team Lead must also be knowledgeable of the application of client policy and industry standards within reviews conducted by CERIS including but not limited to itemized bill review, professional review, hospital outpatient; trend analysis of internal auditing, appeals of pre and post payment claims, and any other claim or record that requires quality review to determine claim accuracy; assist with development of internal quality assurance measures based on client policy and industry guidelines; perform quality assurance reviews; assist in researching and implementing best practices related to payment policy, and/or policy initiatives; researching various healthcare policies....

The Payment Integrity Analyst (Team Lead) assists with leading the Policy and Payment Integrity (PPI) team while maintaining the regular duties and responsibilities of this role which is accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. The Team Lead must also be knowledgeable of the application of client policy and industry standards within reviews conducted by CERIS including but not limited to itemized bill review, professional review, hospital outpatient; trend analysis of internal auditing, appeals of pre and post payment claims, and any other claim or record that requires quality review to determine claim accuracy; assist with development of internal quality assurance measures based on client policy and industry guidelines; perform quality assurance reviews; assist in researching and implementing best practices related to payment policy, and/or policy initiatives; researching various healthcare policies....

Why would you join GM Protection as a Fixed Operations Consultant?   Are you passionate about the automotive service industry and how vehicle service claims keep the world moving? Do you have experience both as a service department technician, advisor, or manager? Have you spent time applying your technical skills and operational knowledge with a vehicle service contract provider or administrator? Do you thrive on helping others perform at the top of their potential? GM Protection is looking for a consultant with these qualities to join our growing team and help drive claims performance at the dealership level. Strategic thinking, creativity, leadership skills, excellent communication, and your ability to enhance dealership performance with data driven methods that align with our Strategic Priorities and Core Values will be essential to your success.   At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity,...

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 role requires internet upload and download speeds of at least 80Mbps.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer phone calls, return phone calls Answer emails from clients, providers and internal referring offices Review previous history of the provider in MedCheck, Scheck and SalesCloud Consult with Supervisor or other departments to clarify answers to inquiries Contact provider to discuss findings at the appropriate level Maintain reports and spreadsheets as needed Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Workers Compensation fee schedules and regulations Effective verbal and written communication skills Good organizational skills and ability to multitask...

Overview **Extended hours may be required during catastrophes or spike claims volume.  Flexibility to travel on short notice, up to 50% of the time, and ability to be on call required. **if selected for this role, in addition to the 10% added to your base hourly rate you are eligible for while on the CAT/Spike Team, the Company is adding a temporary, incentive of 5% to your base hourly rate, for a total incentive of 15%.  The temporary incentive amount is reviewed annually and the Company reserves the right to abandon, amend or modify the incentive at anytime .     Position Summary:   If you’re passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you! Upon completion of the training program, ideal candidates will transition into a property claims field adjusting position traveling to loss sites...

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...