Claims Adjudicator Salary at Usdva BETA

Overview: As the Health Plan Claims Appeal Specialist for a Health Maintenance Organization (HMO), and other Health Plans based in Texas, this position is responsible for investigating and resolving all first level and second level Health Plan Claims Appeals. In reviewing the Claims Appeals, this role is responsible for assessing the appeals to ensure accuracy, compliance with regulations, adjudication is accurate and adherence to company policies is precise. Responsibilities: Essential Functions Conducts reviews of 1st Level Claims Appeals and coordinates with Claims Manager for resolution. Conducts reviews of 2nd Level Appeals and coordinates with designated Executive Team for resolution. Coordinates Claims Appeal adjudication adjustments with Claims Manager. Provides feedback and recommendations to Claims Manager and designated Executive Team for policy changes to reduce Claims Appeals. Collaborates with network providers and the Health Plan Network Team to resolve Appeals and trend

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position Summary** As a Benefit Testing Manager, you will be part of Client Benefit Services QA team that is engaged across multiple functions including Clinical and Benefit Organization, with particular emphasis on solving problems, process improvement and increase automation opportunity within tes

Job Description Job Description We have an immediate opening for a Field Property Claim Representative for the Austin area. This person must be located in the Austin area. The claim representative will be responsible for inspecting, investigating, evaluating, and settling property claims from inception to close. Responsibilities include but are not limited to providing excellent and prompt customer service and customer response; knowing and effectively explaining policy coverage and claim processes; must understand and comply with company claim handling procedures as well as applicable department of insurance regulations; must present him/herself in a professional manner, must have a successful track record of working independently. Candidate must have a minimum of 3 years’ experience adjusting property insurance claims with an emphasis on homeowners claims. Experience with automated claim systems as well as thorough knowledge of Xactimate. Experience handling large losses, taking reco

Job Description The Personal Lines Producer at Murphy Insurance Services is responsible for maintaining and maximizing profitable relationships with personal lines clients and for growing the book of business through new client sales. Benefits/Perks: Competitive Pay Professional Development Job Stability in a growing industry Responsibilities: Identify, qualify, and develop personal insurance opportunities with new and existing clients in person, online, by phone, and through written communication. Foster and maintain excellent relationships with clients and prospects through regular follow-up, accurate and timely quotations, and general account support. Anticipate, respond to, and follow up on all existing client needs. Actively prospect, round accounts, and solicit increases in existing client coverage as well as network for new clients, including win backs. Obtain best coverage/rate for insured, process quotes, and bind insurance coverage; follow up as necessary with inspection, pho

About Texicare Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas. Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare's vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people's lives. We're looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas. Position Summary We are seeking a Lead Actuary to join our team located in Austin, Texas. You will report to the CFO and will be responsible for driving and supporting company strategy and managing actuarial expertise and tools in

About Texicare Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas. Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare's vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people's lives. We're looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas. About the role We are seeking an exceptional Senior Underwriter with experience working across the underwriting function of a health plan, including the Texas market. Specifically, you should have expertise and proven success in v

UFG is looking for a Sr. Production Underwriter to join our team in a multi-line, multi-industry opportunity. In this role you will be responsible for attracting and underwriting middle market business, deploying effective account management while fostering strong working relationships with agency partners. This role executes underwriting strategy to achieve profit and premium plans. The Sr. Production Underwriter will handle a renewal book in their territory as assigned. This role assists with the resolution of escalated issues, and mentors and coaches team members. While this is a remote opportunity the ideal candidate be handling a territory in the Austin or Houston metro areas. Responsibilities: Profitably underwrite complex new and renewal business through risk selection, pricing, contractual integrity, and account management, in accordance with delegated authority, and ensuring regulatory compliance. Demonstrate critical thinking in assessing the risk and identifying exposures an

Claims Analyst SNI Companies has partnered with an amazing Austin third party Automotive Warranty firm with an outstanding reputation and established client base across the country to add new fulltime addition to the team! Hybrid work schedule, Competitive Salary, Bonuses and Benefits package In this role you will support product development, quality control, and cost management strategies across the organization. This position has the potential for supervisory responsibilities in the future. Are you the Ideal candidate? Minimum 3-5 years of claims experience, call center environment prefer Experience in data analysis, preferably within warranty claims or a similar industry Advanced Excel Skills Experience visualization tools like Power BI, Tableau, Zoho, or similar platforms a plus Knowledge of warranty claims processes, or automotive/consumer product warranties is a plus Must have excellent verbal and written communication skills Critical thinking skills Ability to read and understan