Top 924 Claims Adjusters, Examiners, and Investigators Jobs in Houston, TX

Medical Claims Eligibility Specialist II
MET Healthcare Solutions —Houston, TX
- $23 - $25 an hour
- Full-time
- Background check
- Anatomy knowledge
- Surgery
- Health insurance
- Paid time off
Quick Apply
Senior Claims Specialist - Healthcare Professional Liability - Long Term Care
Gallagher Bassett —Houston, TX
- $75,000 - $150,000 a year
- Remote
- Writing skills
- Bachelor's degree
- Computer skills
10d
Principal Investigator Pharmacy - Dallas and Houston, TX
UnitedHealthcare —Houston, TX
- $72,800 - $130,000 a year
- Full-time
- Remote
- Microsoft Word
- Up to 50% travel
- Pass drug screening
Coordinator, Research Data - Lymphoma Myeloma
MD Anderson —Houston, TX
- $21.15 - $31.73 an hour
- Full-time
- Remote
- No experience needed
- Mid-level
- High school diploma or GED
- AD&D insurance
- Paid holidays
21h
Title Examiner
Williston Financial Group —Houston, TX
- $28 - $33 an hour
- Full-time
- Remote
- Microsoft Outlook
- 5 years
- Writing skills
Liability/Claims Specialist
Resource Corporation of America —Houston, TX
- Mid-level
- Bachelor's degree
- Office experience
- Paid holidays
- Health insurance
Quick Apply
Medical Claims Billing Specialist (Fulltime Temp)
Privia Health —Houston, TX
- $25.00 - $26.45 an hour
- Contract
- Hybrid work
- Salesforce
- Medical office experience
- HIPAA
- Work from home
Quick Apply
Medical Claims Billing Specialist
Privia Health —Houston, TX
- $24.00 - $26.45 an hour
- Full-time
- Hybrid work
- Google Workspace
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Claims Specialist II - Veterans Disability Appeals
Allsup Employment Services —Houston, TX
- $17 - $21 an hour
- Full-time
- Remote
- Microsoft Word
- Mid-level
- Mentoring
- Health savings account
- Paid holidays
Quick Apply
Claims Examiner
Texas Children's Hospital —Houston, TX
- Full-time
- Research
- High school diploma or GED
- 1 year
Medical Biller/Claims Processing - Patient Support Representative (Home-Based)
IQVIA —Houston, TX
- $23 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Work from home
6h
Accounts Examiner (Houston)
Texas Workforce Commission —Houston, TX
- $3,446 a month
- Online Application
- Microsoft Excel
- Microsoft Outlook
- Public speaking
- Health insurance
- 401(k)
Research Administration Associate
Baylor College of Medicine —Houston, TX
- $70,618 - $83,080 a year
- Full-time
- Hybrid work
- Mid-level
- Bachelor's degree
- Continuous improvement
13d
Sr. Work Comp Claims Adjuster (Texas)
Elite —Houston, TX
- $75,000 - $83,000 a year
- Hybrid work
- High school diploma or GED
- Analysis skills
- Bachelor's degree
Quick Apply
Mass Tort and Complex Casualty - Complex Claims Director
AIG Claims, Inc. —Houston, TX
- $96,000 - $129,000 a year
- Email
- Office
- Analysis skills
- Criminal background check
- Health insurance
Quick Apply
Claims Examiner
ManhattanLife Insurance & Annuity Company —Houston, TX
- Full-time
- Microsoft Word
- Spanish
- Research
- On-the-job training
Quick Apply
Mass Tort and Complex Casualty - Senior Claims Adjuster
AIG Claims, Inc. —Houston, TX
- $72,500 - $100,000 a year
- Email
- Mid-level
- Office
- Analysis skills
- Health insurance
Quick Apply
Senior Claims Specialist
Gallagher Bassett —Houston, TX
- $75,000 - $150,000 a year
- Remote
- Writing skills
- High school diploma or GED
- Bachelor's degree
6d
Associate Attorney
Roberts Markland LLP —Houston, TX
- From $105,000 a year
- Full-time
- Research
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
Physical Therapist (Sugar Land/Pearland)
Premier Performance Physical Therapy —Pearland, TX
- $85,000 - $110,000 a year
- Full-time
- Background check
- Spanish
- CPR Certification
- Continuing education credits
- Health insurance
Quick Apply

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Claims Adjusters, Examiners, and Investigators jobs near Houston, TX

Medical Claims Eligibility Specialist II

MET Healthcare Solutions -
Houston, TX

Quick Apply

Job Details

Full-time
$23 - $25 an hour

Benefits

Health insurance
Paid time off
401(k) matching

Qualifications

Revenue cycle management
Accounts receivable
Customer communication
Anatomy knowledge
Medical Coding Certification
Bachelor's degree
Health insurance knowledge
Medical terminology
DRG

Full Job Description

MET Healthcare Solutions is seeking a Claim Eligibility Specialist II to join our fast-paced organization. The Claims Eligibility Specialist II will be responsible for analyzing level II claims information to determine eligibility in the dispute resolution process in accordance with established federal regulations and company policies and procedures.

Responsibilities of the Claims Eligibility Specialist II may include but are not limited to:

· Analyze Explanation of Benefits (EOB) and payment remittance documents submitted by healthcare providers and insurance carriers to determine which level II claims are eligible for the dispute resolution process.

· Compose correspondence in accordance with regulatory requirements (and internal policies in procedures) in a clear, concise, and grammatically correct manner.

· Communicate (via email) with healthcare providers and health plans to obtain information necessary to determine the eligibility of the claim.

· Relay the status of all claim submissions utilizing multiple different operating systems.

· Stay up to date on industry specific regulations, ensuring that appropriate strategies are in place.

· Maintain physical and electronic files for all claims determined eligible.

These responsibilities are a condensed list of the full scope of the job description and are subject to change depending on the company’s demand.

· Experience reviewing all types of medical claims, EOBs, and payment remittances (e.g. HCFA 1500, Outpatient/Inpatient UB92, Surgery, Anesthesia, high dollar complicated claims, COB and DRG/RCC pricing).

· Understanding of insurance reimbursement rules.

· Ability to work at a high level and display high attention to detail.

· Ability to work across multiple operating systems.

· Ability to maintain confidentiality and professionalism in difficult situations.

· Strong written and verbal communication skills with the ability to explain reasoning effectively.

This is a full-time position, Monday-Friday from 8am-5pm (office located just north of the Heights). Please only apply if you are able to meet these requirements weekly.

Job Type: Full-time

Pay: $23.00 - $25.00 per hour

Benefits:

401(k) matching
Health insurance
Paid time off

Education:

Bachelor's (Required)

Experience:

Healthcare Claims Analysis: 2 years (Required)

License/Certification:

Billing and Coding Certification (Preferred)

Location:

Houston, TX 77018 (Required)

Ability to Relocate:

Houston, TX 77018: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

Claims Adjusters, Examiners, and Investigators jobs in Houston, TX

Medical Claims Eligibility Specialist II

Senior Claims Specialist - Healthcare Professional Liability - Long Term Care

Principal Investigator Pharmacy - Dallas and Houston, TX

Coordinator, Research Data - Lymphoma Myeloma

Title Examiner

Liability/Claims Specialist

Medical Claims Billing Specialist (Fulltime Temp)

Medical Claims Billing Specialist

Claims Specialist II - Veterans Disability Appeals

Claims Examiner

Medical Biller/Claims Processing - Patient Support Representative (Home-Based)

Accounts Examiner (Houston)

Research Administration Associate

Sr. Work Comp Claims Adjuster (Texas)

Mass Tort and Complex Casualty - Complex Claims Director

Claims Examiner

Mass Tort and Complex Casualty - Senior Claims Adjuster

Senior Claims Specialist

Associate Attorney

Physical Therapist (Sugar Land/Pearland)

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