Claims & Appeals Specialist II
Driscoll Health —Corpus Christi, TX
- Full-time
- Research
- Mid-level
- 3 years
Residential Insurance Estimator
NorthStar Estimating Solutions —Texas
- $75,000 - $120,000 a year
- Part-time
- Remote
- Background check
- Mid-level
- Residential
- Opportunities for advancement
- Flexible schedule
Quick Apply
Automotive Claims Adjuster-Bilingual English/French
Veritas Global Protection Services, Inc —Texas
- $25.50 - $29.50 an hour
- 8 hour shift
- Computer literacy
- English
- Research
- Health insurance
- Dental insurance
Quick Apply
Workers Compensation Claims Examiner III _Corpus_Christi_ (Hybrid)
TRISTAR RISK MANAGEMENT —Corpus Christi, TX
- $75,000 - $85,000 a year
- Full-time
- Remote
- Microsoft Word
- Office
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
Field Claims Assistant
Brezina Claim Associates —Corpus Christi, TX
- Extended hours
- Computer literacy
- Mid-level
- Windows
Casualty Specialist II
First Acceptance Services Inc —United States
- Remote
- Microsoft Excel
- Mid-level
- High school diploma or GED
Manager Claims Casualty
First Acceptance Services Inc —United States
- Remote
- High school diploma or GED
- Analysis skills
- Bachelor's degree
Senior General Liability Litigation Specialist
TheBest Claims Solutions —United States
- $85,000 - $110,000 a year
- Remote
- Senior level
- 2 years
- Commercial

More jobs to discover

Find similar jobs that you might be interested in.

Residential Insurance Estimator
NorthStar Estimating Solutions —Texas
You will evaluate residential damage by reviewing the field inspectors' photos/videos, and collaborate with clients and insurance carriers to facilitate a…
$75,000 - $120,000 a year
Quick Apply
Project Manager
ServiceMaster Restore 3857 - Corpus Christi —Corpus Christi, TX
Project Managers lead our production activities in the field, making decisions that impact the success of the assignment. Working on-call schedule is required.
$50,000 - $75,000 a year
Quick Apply

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Claim Specialist - Property Field Inspection
State Farm Mutual Automobile Insurance Company —Chillicothe, OH
A valid driver's license is required. Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor…
$59,059.65 - $90,000.00 a year
6d
Medical Claims Clearinghouse Specialist
Orthopedic One —Westerville, OH
Responsible for the accurate entry of physician and ancillary charges into Claims Clearinghouse module. Identifies solutions and responds professionally to…

I want to receive the latest job alert for claims adjuster in corpus christi tx

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

claims adjuster jobs near corpus christi tx

Claims & Appeals Specialist II

Driscoll Health -
Corpus Christi, TX

Apply Now

Job Details

Full-time

Qualifications

Appeals
Process audits
Medical Coding Certification
Maintaining patient confidentiality
Research
Mid-level
3 years
High school diploma or GED
Retrospective medical coding audits
Medical insurance appeals management
Trade school
Healthcare fraud detection compliance audits
Acute care experience
Insurance claims auditing
Insurance claims fraud prevention
Associate's degree
Healthcare claims compliance audits
Insurance claims appeal handling
Medical record review for billing accuracy

Full Job Description

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

Candidates must be able to work on-site. This position is not remote.

GENERAL P URPOSE OF J OB :
The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight.

E SSENTIAL D UTIES AND R ESPONSIBILITIES :
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive;
employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.

General Duties:

Maintains the utmost level of confidentiality at all times.
Adheres to hospital and DHP policies and procedures.
Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
Performs other duties as requested.
Claims and Appeals Specialist II Duties and Responsibilities:
Reviews claims appeal and makes recommendations regarding reprocessing/denial of payment.
Research provider’s claims questions.
Works closely with Provider Relations Representatives to assist with provider claim issues.
Provides insight to potential claims payment issues.
Notifies Compliance Officer for DHP of potential fraud and abuse.
Research billing issues.
Responds to providers regarding claims-related issues.
coordination of benefit activities.
Coordinates re-consideration of claims with DHP’s Third Party Claims Administrator
Active member of bi-weekly claims meetings between DHP and DHP’s Third Party Claims Administrator.

E DUCATION AND / OR E XPERIENCE :

High school diploma or general education degree (GED); or associate’s degree (A. A.) or equivalent from two-year college or technical school; three to five years related experience and/or training; or equivalent combination of education and experience.
3 -5 years’ experience of coding in an acute care hospital setting preferred

Apply Now

Refine Your Search

claims adjuster jobs in corpus christi tx

Claims & Appeals Specialist II

Residential Insurance Estimator

Automotive Claims Adjuster-Bilingual English/French

Workers Compensation Claims Examiner III _Corpus_Christi_ (Hybrid)

Field Claims Assistant

Casualty Specialist II

Manager Claims Casualty

Senior General Liability Litigation Specialist

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for claims adjuster in corpus christi tx

Explore jobs in more locations

Where compassion meets innovation and technology and our employees are family.

Job Seeker Tools

Employer Tools

Browse

Stay Connected