12 wealth planner jobs found in Fort Worth

Position Summary: The Account Coordinator Team Leader will oversee the operations and performance of a designated office(s) for the Account Coordinator’s team. This role involves managing a team of professionals, ensuring efficient operations, maintaining compliance, and driving the region toward achieving its strategic goals. The ideal candidate will have strong leadership skills, a thorough understanding of the employee benefits industry, and the ability to adapt to changing market conditions. Supervisory Responsibilities: • Oversees and mentors a team of employee benefit account coordinator employees, providing guidance, support, and performance evaluations • Participates in hiring processes with Talent Operations, onboards new employees, and facilitates ongoing training and professional development on a monthly, quarterly, and yearly basis • Sets performance goals, conducts regular 1:1’s, and implements improvement plans when necessary • Addresses and resolves conflicts...

Position Summary: The Senior Account Manager position maintains a professional relationship with our clients through exceptional customer service. Senior Account Managers are assigned a book of business comprised of mainly level-funded and self-funded accounts. They are 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. Senior Account Managers serve as advocates to our clients and their employees through positive relationships with the various carriers and continuous education. Essential Tasks: Acts as the primary contact between client, prospect, agency, and producer; represents the agency in handling complaints, arbitrating disputes, or resolving grievances Comprehensive knowledge and execution of self-funded accounts Handles or refers all service requests by our clients Initiates and handles marketing of accounts...

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 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 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 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...

Position Summary: The Account Coordinator provides administrative support to internal account managers and maintains a professional relationship with our external clients. Supervisory Responsibilities: None 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 paperwork for submission to carrier –implementation • Attend local enrollment/client meetings as needed • Delivers outstanding customer service • Maintains agency files accurately and consistently • Attends and completes any training sessions or...

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.    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 Strong attention to...

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through verification of coding and...

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...

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...

The hospital bill audit nurse supervisor will maintain a positive team building approach with emphasis on overseeing the day to day functions of hospital bill audit nurses, reporting, leadership and professional communication with all CERiS departments.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate hospital bill audits Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other standard guidelines Assist in the development and support of auditors to meet and exceed productivity requirements based on CERiS productivity standards Act as a point of contact to answer and resolve auditor issues with the goal of providing excellent customer service and relationship management  Perform audits as necessary Keep manager informed of any issues...