- Humana (Springfield, IL)
- …operations for higher quality and operational efficiency. + Ensure enrollment and claims processes comply with regulatory requirements and guidelines. + Partner with ... and regulatory compliance. + Oversee resolution of member enrollment issues, claim disputes, and other reconciliation needs, especially during the Annual Enrollment… more
- Rush University Medical Center (Chicago, IL)
- …This role includes performing re-bills, Debit & Credits, adjustments, refunds, and claim corrections resulting from the multitude of claims and payer ... collected in accordance to contract allowable payment schedule. 2. Follow up on claims with the appropriate payer for reimbursement. 3. Work directly with various… more
- Jacobs (Chicago, IL)
- …for completion within the approved contract time and price. * Implementing claim preventive actions by working with the contractor to proactively resolve issues. ... cause and responsibility, to defend against possible delay or acceleration claims . * Notifying contractor/Contracting Official of any performance or technical… more
- Centene Corporation (Springfield, IL)
- …to external provider related issues + Investigate, resolve and communicate provider claim issues and changes + Initiate data entry of provider-related demographic ... + Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform… more
- UNUM (Springfield, IL)
- …Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits… more
- The Hartford (Chicago, IL)
- …maintain monitoring tools such as actual loss vs expectation. + Partner with the Claims Department to understand claim activity and trends, and inform reserve ... work in close partnership with our Underwriting Divisions as well as Finance, Claims , and IT departments. Responsibilities As a key member of the Global Specialty… more
- CDM Smith (Springfield, IL)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
- Rush University Medical Center (Chicago, IL)
- …and performing actions such as re-bills, debit & credit, adjustments, refunds, and claim corrections resulting from the multitude of claims and payer edits. ... ensure that each account balance is processed correctly. 2. Follow up of claims to the appropriate payer for reimbursement: Work directly with various departments to… more
- Snapsheet (Chicago, IL)
- …direct hire Job Department: Technology About Snapsheet: Snapsheet exists to simplify claims . We leverage our expertise in virtual estimating and innovative claims ... claims process - delivering faster, modern experiences for claims organizations of all sizes. We are looking for...to join one of two core teams at Snapsheet: Claims Management Team Our Claims Management team… more
- Snapsheet (Chicago, IL)
- …Job Type: Full-time, direct hire About Snapsheet: Snapsheet exists to simplify claims . We leverage our expertise in virtual estimating and innovative claims ... the end-to-end claims process - delivering faster, modern experiences for claims organizations of all sizes. Job Overview : The Senior Implementation Engineer at… more