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Claim examiner Jobs in Dallas, TX

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Claim examiner • dallas tx

Last updated: 4 days 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

Claims Examiner

FirstsourceDallas, TX, United States
Full-time

A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications.The claims examiner shoul... 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 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

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

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

Senior Field Examiner

U.S. BankIrving, TX, United States
$119,765.00–$140,900.00 yearly
Full-time

Conducts field examinations of prospective and existing asset-based lending customers in accordance with standard examination procedures.Reviews accounting records of secured loan relationship cust... Show more

Claims Examiner - Commercial GL

Core Specialty InsuranceDallas, TX, United States
Full-time

As the Healthcare Claims Examiner, you will directly handle Commercial Healthcare Claims across the U.Key Accountabilities/Deliverables:.Ensure compliance with established claim handling guidelines... Show more

Senior Registered Nurse - Forensic Exam Team

Parkland Health and Hospital SystemDallas, TX, USA
Full-time

Location: Main Hospital Bldg - 1st Flr.Work schedule: Full-time Nights (36 hours/week), 7:00 p.A Registered Nurse (RN) with >.The RN is a licensed professional who uses the Parkland nursing profess... Show more

 • Promoted

Claim Adjuster

AmTrust Financial ServicesDallas, TX, United States
Full-time

Renter's Insurance Claims Adjuster.The Renter's Insurance Claims Adjuster investigates, evaluates, and resolves first-party renter's claims (personal property, additional living expenses, loss of u... Show more

Senior Claims Examiner, Professional Liability

Arch Capital GroupDallas, TX, United States
$111,100.00–$172,465.00 yearly
Full-time

Professional Liability Claims Manager.With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communit... Show more

AVP Claim Manager

ChubbDallas, TX, United States
$121,100.00–$205,800.00 yearly
Full-time

Brandywine Assistant Vice President Manager.The Brandywine Assistant Vice President Manager is responsible for managing a team of claim professionals handling a blend of complex asbestos, long term... Show more

VP-Liability Complex Claim Director

CONSTRUCTION INSURANCE SERVICES LLCDallas, TX, US
$140,000.00 yearly
Full-time

We are seeking an experienced Liability Complex Claim Director to lead an MGA claims organization.This role combines high-level claims responsibilities with hands-on litigation management across a ... Show more

Senior Field Examiner

U.S. BancorpIrving, TX, United States
$119,765.00–$140,900.00 yearly
Full-time

Bank, we're on a journey to do our best.Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed.We b... Show more

Claims Examiner - Workers Compensation

VytwoDallas, TX, US
$35.00 hourly
Full-time

Title: Claims Examiner - Workers Compensation (1431041).Mandatory: Work comp claims handling experience is needed; loss time.Minimum 3+years of relevant WC experience required.To analyze complex or... 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

Senior Field Examiner

US BankIrving, TX, United States
$119,765.00–$140,900.00 yearly
Full-time

Bank, we're on a journey to do our best.Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed.We b... Show more

Commercial Claims Examiner

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

At Berkley Entertainment, we have over 25 years of underwriting risks in Entertainment & Sports.Our one focus is entertainment insurance.We bring our decades of entertainment experience together to... 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

Guidewire Claim Center Business Analyst - Hybrid

The Dignify Solutions, LLCDallas, TX, United States
Full-time

Hybrid Locations: Alpharetta, GA; Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA; Dallas, TX; Denver, CO; Fargo, ND; Garden City, NY; Houston, TX; Jacksonville, IL; Lenexa, KS; ... 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.