- Allied Universal (Kankakee, IL)
- **Company Overview:** Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- Prime Therapeutics (Springfield, IL)
- …and abuse (FWA) through various mechanisms, including but not limited to: claim adjustments, future payment withholding and coordination with an external collection ... agency. This position ensures payment recoveries are accurately processed in Prime's systems for recoupment of audits and investigations performed by the Pharmacy… more
- Cardinal Health (Springfield, IL)
- …optimize commercial execution to drive profitability and growth. The Trace and Claims function oversees the analytics lifecycle to identify, analyze and present ... and the application of advanced quantitative modeling. The Advisor, Financial Systems Analytics will use different methodologies from various disciplines, techniques… more
- Cardinal Health (Springfield, IL)
- …and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard billing ... is responsible for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following up on unpaid… more
- CVS Health (Springfield, IL)
- …a highly skilled and experienced Senior Product Owner to join our Commercial Claim Adjudication engineering team. As a Senior Product Owner, you will contribute to ... product strategy by: + Leading the development and enhancement of Commercial Claim products or services. + Conducting market research. + Collaborating with… more
- Naval Air Systems Command (Marine, IL)
- …requirements of the Office of Personnel Management (OPM) Job Qualification System for Trades and Labor Occupations (X-118C). Additional qualification information can ... be found at: https://www.opm.gov/policy-data-oversight/classification-qualifications/federal-wage- system -qualifications/#url=WG-3800 You will receive credit for all qualifying experience,… more
- EPAM Systems (Chicago, IL)
- …E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing, NCPDP transactions, and benefit designs + Design test scenarios ... leading large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design +… more
- KPH Healthcare Services, Inc. (Hoffman Estates, IL)
- …balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- CVS Health (Chicago, IL)
- …and share results of analysis with management. + Reserve Analysis: Analyze claim data and monitor reserve levels for appropriateness and demonstrate an understanding ... Develop and finalize business requirements and/or specifications for processes, tools, and systems . You will gain valuable work experience and participate in: +… more
- CVS Health (Springfield, IL)
- …+ Enter and process monthly fee claims for ancillary product offerings via claim system . **Required Qualifications** + 2+ years of experience working in an ... customers and accounts. + Balance deposits in the accounting system . + Follow systems of checks and...own accountability for open items. + Collect and post claim payments against monthly invoices in accounting system… more