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Claim adjuster Jobs in Irving, TX

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Claim adjuster • irving tx

Last updated: 1 day ago

Claims Examiner I

GuidewellIrving, TX, United States
Full-time

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.Training Schedule: Mo... Show more

Commercial Property Claims Desk Adjuster - Remote after training

SedgwickFarmers Branch, Texas, US
Remote
Part-time

By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more

Claims and Risk Manager

Quanta ServicesGrand Prairie, TX, United States
Full-time

NorthStar Energy Solutions is hiring! The Claims & Risk Manager is responsible for leading NorthStar Energy Solutions' incident-to-claim lifecycle, working directly with the Safety and Regional Ris... Show more

Revenue Cycle Management Specialist

TechWishIrving, TX, United States
Full-time

A large dental support organization has implemented Epic across its network of dental practices, demonstrating the value of integrating dental and medical care through a single platform.We are look... Show more

Corporate Claims Specialist

7-ElevenIrving, TX, United States
Full-time

Eleven is an iconic family of brands with over 86,000 locations, surpassing every retailer in the world.We revolutionize convenience, restaurants and fuel through cutting edge innovation working h... Show more

Claims Examiner - Auto

MindlanceIrving, TX, United States
Full-time

Auto casualty experienced in commercial auto liability and coverage.Bodily injury handling experience to include demonstrable mid to high level injury handling.Licensed in the contiguous 48 states.... Show more

Claims Adjuster - Workers Compensation | Juridicition: Midwest States | Licensing: Home State

SedgwickIrving, TX, United States
Full-time

Claims Adjuster - Liability (Hybrid).By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the un... Show more

Workers Compensation Litigation Specialist

W.R. BerkleyIrving, TX, United States
Full-time

Berkley Entertainment Workers Compensation Litigation Specialist.At Berkley Entertainment, we have over 25 years of underwriting risks in Entertainment & Sports.Our one focus is entertainment insur... Show more

Claims Examiner - Auto - Remote / Telecommute

Cynet SystemsIrving, TX, United States
Full-time

Bachelors degree from an accredited college or university preferred.Professional certification as applicable to line of business preferred.Secure and maintain the State adjusting licenses as requir... Show more

Claims Examiner

Arthur LawrenceIrving, TX, US
Full-time

Schedule: Monday to Friday, 8:00 AM – 4:00 PM.Work Setup: Hybrid (1–2 days on-site per week).Review and process standard or less complex insurance claims (electronic and written).Respond to custome... Show more

Workers' Compensation Claim Specialist

AmerisureIrving, TX, United States
Full-time

Workers' Compensation Claims Specialist.Amerisure creates exceptional value for its partners, policyholders, and employees.As a property and casualty insurance company, Amerisure's promise to our p... Show more

Remote A/R Follow-up Manager - AI Trainer ($75-$75 per hour)

MercorEuless, Texas, US
$75.00 hourly
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced A/R Follow-Up Managers to evaluate AI tools designed to automat... Show more

Seasonal Claims Adjuster (Desk)

Orion180 Insurance Services LLCIrving, Texas, United States, 75039
Full-time
Quick Apply

With a dedicated team of experts and cutting-edge technology, CITON Claims Solutions, LLC ensures seamless processes, accurate assessments, and prompt resolutions, delivering unparalleled value and... Show more

Worker' Compensation Coordinator

BrightPath Kids USADallas-Fort Worth, TX, US
Full-time

Location: Dallas Fort-Worth (Hybrid).Schedule: Flexibility required to accommodate multiple time zones.Build your career in the early childhood education field and become a valued member of our tea... Show more

Senior Workers' Compensation Claims Adjuster (Hybrid)

Amerisure Mutual Insurance CompanyIrving, TX, United States
Full-time

Senior Workers' Compensation Claims Adjuster.Amerisure creates exceptional value for its partners, policyholders, and employees.As a property and casualty insurance company, Amerisure's promise to ... Show more

Claims and Risk Manager

AmpacityGrand Prairie, TX, United States
Full-time

NorthStar Energy Solutions is hiring! The Claims & Risk Manager is responsible for leading NorthStar Energy Solutions' incident-to-claim lifecycle, working directly with the Safety and Regional Ris... Show more

Remote Intellectual Property Expert - AI Trainer ($90-$100 per hour)

MercorIrving, Texas, US
$90.00 hourly
Remote
Full-time

Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more

Claims Examiner Auto

IconmaIrving, TX, United States
Full-time

Our Client, a Business Solutions company, is looking for a Claims Examiner Auto for their Irving, TX location.To analyze and process commercial auto transportation claims by reviewing coverage, co... Show more

Claims Examiner I

Blue Cross Blue Shield of FloridaIrving, TX, United States
Full-time

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.Training Schedule: Mo... Show more

Senior Manager Default Services

BurnsSearch, LLCTX-Irving, USA
Permanent

This role will lead the organization's Foreclosure and Claims operations, ensuring timely execution, regulatory compliance, and maximized investor recoveries throughout the foreclosure lifecycle.Th... Show more

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Claims Examiner I

Claims Examiner I

GuidewellIrving, TX, United States
10 days ago
Job type
  • Full-time
Job description

Claim Examiner Position

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.

Key position details:

  • Training Schedule: Monday to Friday 8:00am to 4:30pm Central Time
  • Training Duration: 4 weeks
  • Anticipated training class start dates: 9/14/2026 or 10/12/2026
  • Full Time position

What is your impact?

As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity.

What Will You Be Doing:

  • Day-to-day processing of claims for accounts:
    • Responsible for processing of claims (medical, dental, vision, and mental health claims)
    • Claims processing and adjudication.
    • Claims research where applicable.
    • Reviews and processes insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic).
    • Incumbents are expected to meet and/or exceed qualitative and quantitative production standards.
  • Investigation and overpayment administration:
    • Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers.
    • Overpayment reviews and recovery of claims overpayment; corrected financial histories of patients and service providers to ensure accurate records.
    • Utilize systems to track complaints and resolutions.
  • Other responsibilities include resolving claims appeals, researching benefits, verifying correct plan loading.

What You Must Have:

  • 2+ years related work experience.
  • Claims examiner/adjudication experience on a computerized claims payment system in the healthcare industry.
  • High school diploma or GED
  • Knowledge of CPT and ICD-10 coding required.
  • Knowledge of COBRA, HIPAA, pre-existing conditions, and coordination of benefits required.
  • Must possess proven judgment, decision-making skills and the ability to analyze.
  • Ability to learn quickly and multitask.
  • Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers.
  • Concise written and verbal communication skills required, including the ability to handle conflict.
  • Proficiency using Microsoft Windows and Word, Excel and customized programs for medical CPT coding.
  • Review of multiple surgical procedures and establishment of reasonable and customary fees.

What We Prefer:

  • Some college courses in related fields are a plus.
  • Other experience in processing all types of medical claims helpful.
  • Data entry and 10-key by touch/sight

General Physical Demands: Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.