- Evolent (Springfield, IL)
- …coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review. + Ensure compliance and quality ... problem-solving skills, and proficiency in clinical documentation requirements. **Qualifications Preferred :** + Clinical knowledge of chronic conditions and comorbidities.… more
- Prime Therapeutics (Springfield, IL)
- …stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business partners ... experience maintaining, tracking, renewing and submitting applications for licensure ** Preferred Qualifications** + PBM/health care experience + Certified Compliance… more
- Rush Enterprises (Chicago, IL)
- …guidelines and policy. + Process and maintain all returned parts, file freight claims on damaged parts upon reciept. Basic Qualifications: + High school diploma or ... general education diploma (GED). + Related experience preferred + If required to drive, for any reason, on behalf of the company, must possess a current and valid… more
- AbbVie (North Chicago, IL)
- …range of legal, regulatory and compliance issues, including FDA regulations, False Claims Act, Anti-Kickback Statute, OIG guidance, the PhRMA Code, the Sunshine Act, ... highly complex transactions. Experience with both M&A and Licensing is preferred / + Developing proficiency in practice area. Additional Information Applicable only… more
- CVS Health (Buffalo Grove, IL)
- …NextGen Production Support Environment team, focusing on Non-Production Support: + Claims system: Health Rules Payer (HRP) + Enrollment systems: Market Prominence ... in or leading dynamic, cross-disciplinary teams through issue resolution. ** Preferred Qualifications** + Experience with Java/J2EE, Oracle Weblogic, Apache Karaf,… more
- Prime Therapeutics (Springfield, IL)
- …that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given ... such as Scrum, Project Management Institute (PMI), Business Analysis ** Preferred Qualifications** Every employee must understand, comply with and attest… more
- Walgreens (Chicago, IL)
- …payment rejections. Resolves third party rejection problems promptly, and resubmits rejected claims for payment on a timely basis. + Manages and controls ... services offered at clinic location (HIV, Organ Transplant, Oncology, etc.). ** Preferred Qualifications:** + Previous experience at a Walgreens Local Specialty… more
- Johns Hopkins University (Chicago, IL)
- …health and wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. + Provide crisis ... Equivalent, to the extent permitted by the JHU equivalency formula. ** Preferred Qualifications** + Minimum twelve months of related experience (adult medicine).… more
- Robert Half Accountemps (Chicago, IL)
- …through inbound and outbound calls, addressing inquiries and resolving service or claims -related issues. * Assist customers who wish to cancel their insurance ... organizational objectives. Requirements * High school diploma required; bachelor's degree preferred . * Proficient in both Spanish and English, with excellent verbal… more
- Danaher Corporation (Richmond, IL)
- …complaint handling, adverse event escalation, recall, product classification, and product claims ), execution of field action activities, and ensuring compliance of ... with customers, cross-functional project teams and regulators. + Certifications preferred : Quality Management, Quality Auditor, Lead Auditor, Six-Sigma Black Belt,… more