Talent.com

Claims Jobs in Dallas, TX

Create a job alert for this search

Claims • dallas tx

Last updated: 1 day 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 Manager - Insurance and Claims Department

Menzies AviationDallas, TX, United States
Full-time

Manager Insurance and Claims, Americas.This position is within the Insurance & Claims Department, based out of our Dallas Fort Worth head office.Reporting to the Director of Insurance & Claims, the... Show more

Claims BUSINESS ANALYST

RIT SolutionsDallas, TX, United States
Full-time

Hybrid 3 Days a week: Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA; Dallas, TX; Fargo, ND; Garden City, NY; Houston, TX; Jacksonville, IL; Lenexa, KS; Los Angeles, CA; Lubbock... 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

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

Insurance Claims Specialist

AutoNation Mobile ServiceIrving, TX, United States
$28.00–$30.00 hourly
Full-time

The primary objective of this position is the timely and satisfactory resolution of insurance claim situations resulting from damage to or loss of the vehicle, including negotiation of settlements.... 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

Commercial Claims Trainer

KemperDallas, TX, United States
Full-time

Kemper is one of the nation's leading specialized insurers.Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every d... Show more

Claims Adjuster I

Bluefire Insurance Services LLCDallas, TX, United States
Full-time

Handles of claims which may have multiple featured identified upon report or likely to arise during the investigation of the claim including collision, comprehensive, physical damage and unrepresen... Show more

Claims Intake Specialist

Orion180Irving, TX, United States
Full-time

CITON Claims Solutions, stands out as a leading provider of claim management and administration services tailored specifically for insurance companies.We pride ourselves on delivering efficient and... Show more

Claims Representative, Warranty

Cornerstone Building BrandsDallas, TX, United States
$22.00 hourly
Full-time

Claims Representative, Warranty.The Claims Representative is responsible for managing warranty claims from initial intake through final resolution while delivering a premier customer experience.Thi... 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

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

Indemnity Claims Adjuster

CorVelIrving, TX, United States
$52,999.00 yearly
Full-time

The Indemnity Claims Adjuster manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible out... 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

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

ESIS Claims Associate

ChubbDallas, TX, United States
Full-time

Are you ready to make a meaningful impact in the world of workers' compensation or auto & general liability claims? Join ESIS, a leader in risk management and insurance services, where your skills ... Show more

Claims Litigation Specialist

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

Berkley Southwest offers commercial property and casualty products and services through independent agents in Arizona, Arkansas, New Mexico, Oklahoma and Texas.We maintain a strong local presence i... Show more

People also ask
The cities near Dallas, TX that boast the highest number of claims jobs are:
The highest-paying jobs are:
The top 10 cities are:
Claims Examiner

Claims Examiner

Sigma Systems, Inc.Irving, Texas, United States
4 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.