- Sedgwick (Springfield, IL)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker, ... support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues… 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
- CVS Health (Rantoul, IL)
- …in compliance with network management and clinical coverage policies. BH Case Manager is responsible for telephonically and/or face to face assessing, planning, ... including co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case management and eligibility.… more
- World Insurance Associates, LLC. (Westmont, IL)
- …excellent service, and professional communication + Handling renewals, service requests, claims , billing and new policies + Maintain a thorough understanding of ... Review all applications, policies, endorsements and audits for accuracy + Complete loss/ claim analysis and summaries + Coordinate expiration list with department … more
- GE HealthCare (Chicago, IL)
- **Job Description Summary** The Insurance & Corporate Risk Manager plays a key role in executing GE HealthCare's global risk management strategy. This position is ... responsible for managing insurance program operations, claims oversight, and compliance activities. Operating with autonomy within established frameworks, the Risk … more
- Walmart (Joliet, IL)
- …assigned area of work Creates action plans to address audit findings Validates claim records work with workers compensation case managers for investigation of ... claims Asset Protection Security Possesses knowledge of Asset protection policies practices and guidelines environmental health and safety laws and regulations To be… more
- Travelers Insurance Company (Downers Grove, IL)
- …+ Develop and maintain effective relationships with internal resources (eg, Claim , Operations, etc.) to coordinate the delivery of all related services ... direct management of staff. + Two years of experience in underwriting, service, sales, claims , and/or operations. **What Is in It for You?** + **Health Insurance** :… more
- Sedgwick (Chicago, IL)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey....professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement, access, and coverage issues for our products, ... staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- CDM Smith (Chicago, IL)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more