- Walgreens (Chicago, IL)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Humana (Springfield, IL)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
- Elevance Health (Chicago, IL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
- MetLife (Aurora, IL)
- …quality and performance standards. * Evaluating and improving business and associate performance by effectively conducting quality evaluations of Short Term ... Disability (STD), State Plans, PFML, and concurrent Absence Management Solutions (AMS) claims to ensure we meet or exceed customer expectations. Will engage business… more
- Sysco (Hampshire, IL)
- …the performance management process and work with functional leaders on their associate reviews and evaluations. Provide training and consultation, as necessary. + ... (EEOC) compliance. Perform investigations and prepare written responses to EEOC claims , unemployment claims , etc. + Work with region leaders to create and… more
- Sedgwick (Moline, IL)
- …quickly to change **Education & Licensing** HS diploma or GED required. Associate degree from an accredited college or university preferred. Active property & ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Evolent (Springfield, IL)
- …require technical experts to find the most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs may be engaged in any testing ... - Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in… more
- Walgreens (Evanston, IL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Zurich NA (Chicago, IL)
- …and coordinating with the appropriate business partner for resolution (ie claims adjusters, underwriters). + For new and existing customers, assist underwriting ... regulatory requirements, reporting, risk engineering coordination, premium payment processes, claims flow issues, and money/currency movement. + Handle specific… more
- Robert Half Accountemps (Naperville, IL)
- Description We are looking for an Account Specialist, Associate to join our team in Houston, Texas. This long-term contract position offers an opportunity to provide ... teams to develop effective solutions to complex customer issues. * Process claims , contractor invoices, and enrollment requests with accuracy and efficiency. *… more