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Claims examiner Jobs in Dallas, TX

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Claims examiner • dallas tx

Last updated: 12 hours ago

Claims Examiner

Sigma Systems, Inc.Irving, Texas, United States
Full-time +1
Quick Apply

Claims Examiner Irving, TX 3 Months contract.Work Schedule: 5 Days - 8 Hours.The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in... Show more

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

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

Commercial Auto Claims Manager.Credit security clearance, confirmed via a background credit check, is required for this position.Processes commercial auto bodily injury claims and ensures claim fil... Show more

Claims Examiner - Auto

SynecticsIrving, TX, United States
Full-time

Seeking a Claims Examiner to analyze and process commercial auto transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.An... Show more

 • New!

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 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

Senior Claims Analyst/Claims Manager, Commercial Auto

StarrcompaniesDallas, TX, United States
Full-time

Starr, a global leader in commercial insurance with over a century of expertise, empowers its employees to innovate, make impactful decisions, and build lasting client relationships worldwide.At St... 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

Associate FCA Examiner

US Government Jobs - Other AgenciesIrving, TX, United States
Full-time

Student Trainee (Associate FCA Bank Examiner).As a Student Trainee (Associate FCA Bank Examiner), you will be responsible for gaining hands-on experience in financial institution examination work.C... Show more

 • New!

Claims Manager

Crow HoldingsDallas, TX, United States
Full-time

Trammell Crow Residential (TCR) is a leading multifamily real estate developer with a local presence in 16 key U.Over 45 years, TCR has built more than 292,000 premier multifamily residences, deliv... 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

Senior Workers' Compensation Claims Examiner - Federal Claims

AIGDallas, TX, United States
$73,000.00–$96,000.00 yearly
Full-time

Senior Workers Compensation Claims Examiner.At AIG, we are reimagining the way we help customers to manage risk.Join us as a Senior Workers Compensation Claims Examiner to play your part in that tr... Show more

Commercial Auto & General Liability Claims Examiner III

TRISTAR Insurance GroupIrving, TX, United States
$85,000.00–$95,000.00 yearly
Full-time

Commercial Auto & General Liability Claims Examiner III.Fully Remote Dallas - Irving, TX 75038.Salary/year Level Experienced Position Type Full Time Job Shift Day Education Level Bachelor's Degree... 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 Specialist

BITCO Insurance CompaniesIrving, TX, United States
Full-time

Old Republic BITCO is seeking a Sr.Claims Specialist to join our branch office located in Dallas TX.As a respected specialty insurer with 11 branch offices across 10 states, OR BITCO delivers tailo... 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 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

Claims Adjuster

Brown & BrownDallas, TX, United States
Full-time

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.Brown & Brown is seeking a Claims Adjuster to join our gro... Show more

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Claims Examiner

Claims Examiner

Sigma Systems, Inc.Irving, Texas, United States
2 days ago
Job type
  • Full-time
  • Temporary
  • Quick Apply
Job description

9151476 - Claims Examiner Irving, TX 3 Months contract
Sigma Inc. is currently looking for a Claims Examiner in Irving, TX.

Shift Timings: Work Schedule: 5 Days - 8 Hours

Summary:

  • The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations.
  • This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.

Responsibilities:

  • Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
  • Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations.
  • Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc.
  • Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
  • Process provider refunds, reconsiderations, and direct member reimbursements.
  • Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication.
  • Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager.
  • Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes.
  • Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management.
  • Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude.
  • Contacting/responding to internal and external customers for resolution on claim issues.
  • Assist claims leadership to identify claim trends, gaps in workflow and create/update desktops and policies and procedures.
  • Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.
  • Must be able to organize and prioritize work to meet deadlines.
  • Have good judgment, initiative, and problem-solving abilities.
  • Attention to detail is critical to ensure timely and accurate processing of claims.
  • Consistently meet established productivity and quality standards.
  • Follow CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).
  • Performs other duties as assigned by management to support claims functions, which are focused on achieving both departmental and organizational objectives.
  • Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.
  • Must have excellent written, verbal, organizational and interpersonal communication skills.
  • Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.


Job Requirements:

  • Associate's degree or equivalent job-related experience required.
  • Minimum of 3 years' experience processing medical claims in the healthcare industry.
  • Prior experience working with managed care, Medicare, Medicare Advantage, Health Exchange, and TRICARE are highly desirable.