- Sedgwick (Springfield, IL)
- …qualified opinion as to the cause of loss. + Receives and reviews new claims and maintains data integrity in the claims system. **ADDITIONAL FUNCTIONS and ... pounds. + Be able to drive up to 4 hours per day. + Must have continual use of...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- AbbVie (North Chicago, IL)
- …ensure benefits are provided in accordance with AbbVie policies. + Manage worker's compensation claims greater than 40 hours of loss time to ensure appropriate ... on return-to-work status questions regarding job protection, workers' compensation claims , transition from active employment, questions relating to absence and… more
- Intermountain Health (Springfield, IL)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up on ... contractual arrangements affecting payments, to research incomplete, incorrect or outstanding claims and/or patient issues. Investigates and resolves claims … more
- Superior Ambulance Service (Elmhurst, IL)
- …Tasks within 72 hours of receipt + Responsible for resolving unpaid claims that are Greater than 60 days from date of service + Reviews previously ... clients. Specific tasks include resolving insurance carrier denials, appealing claims , contacting carriers on open accounts and responding to...worked claims a minimum of every 30 days + Responsible… more
- CenterWell (Springfield, IL)
- …+ Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations, ... up tasks for medication reconciliation/education. + Processing of select medication claim updates (lists) as requested by the clinical pharmacists or providers.… more
- Humana (Springfield, IL)
- …responsible for estimates of short term and long term reserves required for unpaid claim liability, active life reserves, and other actuarial items that ought to be ... Actuary, Valuation is responsible for estimates of reserves required for unpaid claim liability, including incurred but not reported (IBNR) reserves for all Humana… more
- Humana (Springfield, IL)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS + ... field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing...protect member PHI / HIPAA information **Additional Information** + Hours : Monday-Friday with a start time between the … more
- Humana (Springfield, IL)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... your skills to make an impact** **WORK STYLE:** Remote/Work at home **WORK HOURS :** Associates will work on EST, regardless of where the associate resides. Work… more
- Intermountain Health (Springfield, IL)
- …an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others by effectively ... English. **Skills** + Recognizing true overpayments from false credits + Researching claim cycle + Understanding Coordination of Benefits + Understanding EOB +… more
- Humana (Springfield, IL)
- …2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives, ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
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