- CVS Health (Chicago, IL)
- …and key performance metrics for reconciliation, revenue cycle, and adjudication/ claims processes analysis. Facilitate effective solutions related to adjudication and ... processing of pharmacy and vaccine/medical claims , maintaining current services, support optimalization of existing vendor product portfolio, provide continual… more
- Reynolds & Reynolds (Warrenville, IL)
- …coverage and terms -\tAccurately establish, review and authorize claims -\tEntering claim and contract information into the AGWS\u2019 system Training On ... an affiliate of Reynolds and Reynolds, is seeking a Claims Adjuster - Automotive for our growing team at...but are not limited to:-\tAnswering inbound calls-\tProvide information about claim processing and explain the different levels of contract… more
- Prime Therapeutics (Springfield, IL)
- …decision we make. **Job Posting Title** Principal Solution Product Owner - Pharmacy Claims Data **Job Description** The Pharmacy Claims Data Principal Solution ... analytics needs to capture, refine and prioritize the pharmacy claim data product backlog. The Product Owner will capture...+ 8 years of work experience leading business processes, system changes and/or similar relevant business experience + Must… more
- Axis (Chicago, IL)
- …particularly within claims operations. + 5+ years of experience with Claims Admin systems , preferably Duck Creek or similar platforms. + Proficiency ... available upon request for candidates taking part in the selection process. ** Claims Business Analyst** **How does this role contribute to our collective success?**… more
- Zurich NA (Schaumburg, IL)
- Bachelor Apprenticeship Program - TPA Claims - Schaumburg, IL (January 2026) 125128 Have you completed two or more years of college and are looking to finish your ... North America is offering Complete-a-Bachelor's Apprenticeship opportunities in TPA Claims . Apprentices who successfully complete this two-year program will: +… more
- Trustmark (Lake Forest, IL)
- …gathering and design sessions with stakeholders as it relates to software systems and/or applications (cloud and/or on-premises). Translates product vision to the ... MSP team, disseminating knowledge, technical requirements, and design documentation. Identifies and evaluates project constraints and risks. Researches and monitors new technologies, frameworks, and tools that would improve development workflows and optimize… more
- Travelers Insurance Company (Downers Grove, IL)
- …evaluating, reserving, negotiating and resolving assigned General Liability - Public Sector claims . Provides quality claim handling throughout the claim ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...quality standards and trend analysis. + Utilizes diary management system to ensure that all claims are… more
- Humana (Springfield, IL)
- …claim studies, and performing duplicate claim detection through the DHA Duplicate Claims System (DCS). + Research and review claims for internal focus ... pre-payment, high dollar claims to assess payment accuracy and identify potential claim payment risks. The Claims Risk Management Professional is expected to… more
- CVS Health (Springfield, IL)
- …Medicaid Intake Business Operations team seeks an analyst with expertise in electronic claim transactions and claims operations. This team ensures the quality ... and integrity of Intake processes for all Medicaid incoming claim transactions. In this position, you will provide initial...with EDI Product Owners and Technology teams to identify system enhancements and bug fixes. You will also outline… more
- CVS Health (Springfield, IL)
- …with GPS, SCM, ECHS, and Total Payment Solution (TPS) * Knowledge of ACAS claims systems * Familiarity with e.Policies **Anticipated Weekly Hours** 40 **Time ... tied to different overpayment projects in the Overpayment Tracking System , revalidate overpayment files, send claims to...instructions provided by our constituents to properly review ACAS claims for overpayment * Utilize GPS for claim… more