69 adjudication jobs at 38 companies in Texas
5d
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Supervisor - Pharmacy Adjudication
Houston, Texas, United States
$46k/yr OnsiteFull Time
4+ YOEHigh school diploma or GED, 4+ years of pharmacy or adjudication experience, leadership experience, pharmacy registration, and knowledge of billing, insurance, claims, audits, and benefits coordination.
NDC, PBM, NCPDP, Pulse
2mo
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Supervisor (Clinical Adjudication) (Part C)
Austin, Texas, United States
RemoteFull Time
5+ YOEAssociate's degree or equivalent experience; 5+ years conducting or overseeing Medicare appeals/medical review; supervisory experience; clinical background (nursing, PT, RT, OT); strong written and oral skills.
2mo
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Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling
Austin or United States
RemoteFull Time, Part Time
5+ YOEAssociate's degree (or 60+ college credits) in healthcare or equivalent experience; 5 years conducting/overseeing Medicare appeals/medical review; supervisory experience; clinical background (nursing, PT, RT, OT) and experience making medical necessity decisions.
4d
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Senior Manager, Software Development Engineering (Claims Adjudication)
Richardson, Texas, United States
$118k-$237k/yr HybridFull Time
7+ YOE7+ MgmtRequires 7+ years of IT experience, development management and leadership, 5+ years of IBMi technology development, team leadership, customer relationship management, and a bachelor's degree or equivalent experience.
IBMi, AS400
1w
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Detention Counselor - Juvenile Probation - Juvenile Post Adjudication
Denton, Texas, United States
$68k-$79k/yr OnsiteFull Time
1+ YOEMaster's in counseling or related field plus minimum 1 year related experience; Texas licensure (LPC/LMFT/LMSW/LCSW family of credentials) required; ability to complete Juvenile Supervision Officer certification; valid driver's license.
1w
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Shift Supervisor - Juvenile Justice Post-Adjudication - J2950 - 34920
Corpus Christi, Texas, United States
$23/hr OnsiteFull Time
2+ YOEHigh school diploma or GED, age 21+, and two years of experience in corrections, law enforcement, residential care, military service, teaching, or youth work. Requires Texas driver's license and juvenile supervision certification.
1mo
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Claims Consultant
Arlington, Texas, United States
$48k-$55k/yr OnsiteFull Time
4+ YOEReview and adjudicate disability/FMLA/PFL claims, analyze medical records, determine benefits, communicate with claimants and clients, and manage escalations.
FINEOS, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
3w
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Claims Examiner
Bellaire, Texas, United States
OnsiteFull Time
1+ YOEHigh school diploma/GED and at least 1 year of claims examination experience; ability to adjudicate claims accurately and document findings.
1mo
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Claims Supervisor
Corvallis or Alabama or Alaska or Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or Rhode Island or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
4+ YOE2+ MgmtHigh school diploma, 4 years claims experience (adjudication/benefits/COB), 2 years leadership, strong communication and problem-solving skills.
3d
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Immigration Services Officer
Lincoln or Irving
$41k-$127k/yr OnsiteFull Time
U.S. citizenship, specialized immigration adjudication experience or qualifying education, background investigation, drug screening, and ability to complete USCIS basic officer training.
USAJOBS, USA Hire, Electronic systems, E-Verify
1mo
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Senior Paralegal
San Antonio, Texas, United States
$50k-$58k/yr OnsiteFull Time
3+ YOE3+ years legal support experience, 2-year paralegal degree or paralegal certificate, proficiency with Microsoft Office, U.S. citizenship and ability to obtain background adjudication.
Microsoft Word, Microsoft PowerPoint, Microsoft Excel, Microsoft Outlook
4d
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Healthcare QA Lead – ACAS Claims Testing
Hartford or Dallas
$71k-$113k/yr HybridFull Time
9+ YOERequires 9+ years in healthcare payer domain, ACAS and claims-system testing, claims adjudication knowledge, test strategy and execution, defect management, SQL, and Jira.
ACAS, ClaimsXten (CXT), SQL, Jira
3w
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Certified Pharmacy Technician (Meds-To-Beds) - Full Time - JPS Health
Fort Worth, Texas, United States
$25/hr OnsiteFull Time
1+ YOEActive Texas pharmacy technician license and national CPhT, 1+ year pharmacy experience, knowledge of pharmacy procedures, insurance adjudication, inventory, EMR and customer service.
EMR
2mo
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Cognitive Performance Specialist (51443)
Laughlin AFB, Texas, United States
$70k-$75k/yr OnsiteFull Time
2+ YOE2+ years in cognitive performance services; Master’s degree in psychology, counseling, or related field; CPR/AED; ability to obtain Tier 3 security adjudication; on-base work.
Microsoft Suite (Outlook, Teams, Word, Excel, PowerPoint)
4w
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Sr Manager, Life & Annuities Claims
Tulsa or New Orleans or Charleston or Bellevue or Plano or Detroit or Nashville or New York City
HybridFull Time
8+ YOE3+ MgmtBachelor's or equivalent,8+ years life & annuities claims experience,3+ years managing claims operations,expertise in claims adjudication,operational controls,analytics,and stakeholder management.
4d
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Life Insurance Claims Analyst
Dallas, Texas, United States
OnsiteFull Time
3+ YOERequires 3 years of life insurance claims adjudication, college coursework or equivalent experience, strong mathematics, contract interpretation, analytical, organizational, communication, and customer service skills.
Microsoft Excel, Microsoft Word, Oracle Discoverer
1w
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Sr Dir, Res Life & Judicial Aff
Victoria, Texas, United States
$6k/mo OnsiteFull Time
5+ YOEMaster's degree in student counseling, psychology, or related field and five years of related experience. Requires staff supervision, student conduct adjudication, residence life leadership, and crisis response.
3w
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Claims Finance Manager
Frisco, Texas, United States
OnsiteFull Time
5+ YOEBachelor's degree,5+ years finance or claims experience,advanced Excel skills,knowledge of claims adjudication and payment integrity,financial analysis and reporting,leadership and cross-functional collaboration.
Microsoft Excel
3d
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Pharmacy Technician - Care Team (Bilingual)
Miami or New York City or Denver or Dallas
$23/hr RemoteFull Time
1+ YOEBilingual English/Spanish pharmacy technician with active PTCB or NHA certification, 1–3 years of pharmacy technician experience, and knowledge of claims adjudication, benefit design, and PBM terminology.
AI-enabled tools
1w
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Sr Dir, Res Life & Judicial Aff
Victoria, Texas, United States
$6k/mo OnsiteFull Time
5+ YOEMaster's degree in student counseling, psychology, or related field and five years of related experience. Requires leadership, staff supervision, student conduct adjudication, crisis response, and policy administration.
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