Senior Appeals Operations Coordinator — Medicare & Claims
CVS Health
A leading health solutions company in Austin, Texas, is seeking a Senior Coordinator for Complaint Appeals Operations. This role involves researching and resolving various appeals, coordinating cross-departmental efforts, and addressing complaints. Candidates should possess strong communication skills and knowledge of Medicare. The position offers full-time hours and a competitive salary range, alongside comprehensive benefits aimed at investing in employees' well-being. #J-18808-Ljbffr CVS Health
$18.5 - $35.29 per hour
Senior Coordinator Complaint Appeals Operations At CVS Health, we’re building a world of health around every consumer... ...for decision. Able to research claim processing logic and various systems... ...customer service skills. Medicare knowledge/experience. Preferred Qualifications...SeniorClaimsHourly payFull timeLocal areaFlexible hours$20 - $25 per hour
...* Job purpose ~ The Appeals Specialist is responsible for... ...insurance denials by reviewing claims and clinical documentation,... ...patient billing questions Coordinates medical and billing records payments... ...to job accomplishments Operates standard office equipment (e....ClaimsFull timeWork experience placementWork at officeLocal areaRemote work- Humana Inc. is seeking a Senior Provider Contracting Professional to lead the negotiation... ...health providers in Indiana Medicaid and Medicare. This fully remote role requires strong network... ...relations, particularly with Medicare claims, and the capacity to manage multiple...SeniorClaimsRemote job
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$3,100 - $4,500 per month
The Texas Workforce Commission in Austin, Texas is seeking an Interstate Unemployment Insurance Claims Examiner II - III. In this role, you will manage complex unemployment insurance overpayment cases, ensuring accuracy and communicating effectively with claimants. Ideal...SeniorClaims- Work At Home Vintage Experts in Austin, Texas, is seeking a Commercial Auto Claims Adjuster to manage insurance claims from home. You will handle a caseload, ensuring compliance and timely resolution. The role requires extensive experience in auto claims adjusting and...SeniorClaimsFull timePart timeRemote workWork from home
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...recruitment agency is seeking a Field Property Adjuster Specialist in Austin, Texas. You will explore and resolve complex property insurance claims, collaborating with various stakeholders for effective outcomes. The ideal candidate should have a high school diploma, two years...SeniorClaims- A leading clean energy firm in Austin is seeking a claims manager for oversight of insurance claims management, including Builders All Risk claims. The ideal candidate will have 4-7 years of insurance-related experience and a degree in a business-related field. Responsibilities...SeniorClaims
- ...culture. The Opportunity Quest Software is seeking a Senior Specialist, Global HR Operations to support and evolve our global HR Operations model.... ...approached in this way and only interact with people claiming to be Quest employees if they have an email address...SeniorClaimsFlexible hours
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$21.97 - $35.14 per hour
...based in Austin, TX is looking for someone to provide high-level service to clinicians and patients by assisting with data accuracy for claim submission. Candidates should have a high school diploma or GED and a minimum of 3 years experience in a hospital/clinical...ClaimsRemote jobHourly payWork at office$21.97 - $35.14 per hour
...Partners in Austin, Texas, is seeking a detail-oriented professional to provide high-level service by assisting with data accuracy for claim submissions. Responsibilities include maintaining effective relationships with hospital staff, processing medical records, and...ClaimsHourly pay$29.05 - $67.97 per hour
...seeking a qualified Registered Nurse to handle clinical reviews. This role involves assessing medical necessity, validating claims, and facilitating appeals. Candidates should have a minimum of 2 years of clinical nursing experience. The position offers financial...ClaimsHourly pay$70.9k - $76.9k
Ryder System, Inc. is seeking an experienced professional in Risk Management to handle Auto Liability claims under its self-insured program. The position involves investigating and adjusting claims, managing litigation, and collaborating with various stakeholders. A Bachelor...SeniorClaimsFull time- ...insurance ~ Health insurance ~ Vision insurance Insurance Operations Coordinator Location: Austin, TX (Remote considered for exceptional... ...) and Managed Repair Program (MRP) operations by ensuring claims move efficiently from assignment through scheduling and...ClaimsFull timeWork at officeImmediate startRemote workFlexible hours
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...Sedgwick is looking for a skilled professional in Austin, Texas, to manage complex claims and high-end injury cases. The role requires ten years of litigation experience, along with five years in claims management. A Bachelor's degree is preferred. The position offers...SeniorClaims$21.97 - $35.14 per hour
Overview Responsible for providing high level service to our clinicians and patients by assisting with accuracy of data for claim submission. Performs business office duties that support the anesthesia practice and requires the ability to multi‑task efficiently. Location...ClaimsHourly payWork at officeLocal areaRemote work- ...Senior Claims Specialist As a senior claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve injury claims. Investigating complex and high-risk claims – which may be attorney represented or have additional litigation...SeniorClaimsWork at officeMonday to Friday
- ...needs. This remote role requires strong skills in SQL programming, experience with clinical stakeholders, and understanding of health claims data. Responsibilities include system integration projects, conducting financial analyses, and collaborating on departmental goals....SeniorClaimsRemote work
- ...Senior Claims Specialist Attention military affiliated job seekers - our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, transitioning military, National Guard and Reserve members...SeniorClaimsWork at officeMonday to Friday
- ...professional to manage a billing team. The ideal candidate will have 4+ years of experience in Medicare billing and insurance verification. Responsibilities include overseeing claims processes and ensuring compliance with coding standards. This position offers great pay and...SeniorClaimsFull time
- Central Health in Austin, Texas is looking for a Health Plan Claims Adjudicator responsible for processing health plan claims to ensure accuracy and compliance with regulations. Candidates should have at least 5 years of experience in health plan claims adjudication, ideally...SeniorClaims
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...regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate... ...review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited...ClaimsHourly payWork experience placementWork at office- CHU is seeking a Senior Loss Adjuster to manage large loss claims and mentor the team. The role requires a minimum of 5 years of experience in property claims and loss adjusting, expertise in negotiating settlements, and thorough knowledge of commercial and residential...SeniorClaimsFlexible hours
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$55k
Foundation Communities owns and operates two Prosper Centers in Austin, Texas where thousands of community members access free... ...wellness programs, and college support services. The Senior Operations Coordinator is responsible for supporting the day‑to‑day operations of...SeniorFull timeWork at officeAfternoon shift$15k
A leading insurance firm based in Austin, Texas, is seeking an Experienced Surety Bond Desk Adjuster to handle losses and claims up to $15,000. The role involves investigating and resolving claims related to surety bonds, requiring strong analytical skills and knowledge...SeniorClaims- ...Senior Vice President, Workers' Compensation & Motor Vehicle Accidents About the Company... ...defining and executing the strategic vision, operating model, and growth roadmap for these... ...focus on increasing revenue and managing claims efficiently. This role requires the ability...SeniorClaims
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