• Pharmacy Order Entry Technician

    BrightSpring Health Services (Bensenville, IL)
    …+ Triage, interpret and input orders into computerized medication order system while meeting accuracy and productivity standards of the pharmacy. Audits ... resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current...of Sale (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and… more
    BrightSpring Health Services (07/28/25)
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  • Account Executive/Broker III - Personal Lines

    AON (IL)
    …+ Maintains awareness of all insurance carrier partner products, services and systems . + Fully utilizes internal client management system to maintain ... + Maintains awareness of all insurance carrier partner products, services and systems . + Fully utilizes internal client management system to maintain… more
    AON (07/26/25)
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  • Customer Service Representative-Must Reside in

    CVS Health (Springfield, IL)
    …Explains member's rights and responsibilities in accordance with contract. Processes claim referrals, new claim handoffs, nurse reviews, complaints ... (member/provider), grievance and appeals (member/provider) via target system . Educates providers on our self-service options; Assists providers with credentialing… more
    CVS Health (07/16/25)
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  • Complex Denials Consultant

    R1 RCM (Chicago, IL)
    …solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the ... + Review and apply client contract language and rates to resolve denied claims . + Utilize payer-provider and administrative manuals to dispute denied claims .… more
    R1 RCM (07/29/25)
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  • Automotive Customer Service Representative

    Reynolds & Reynolds (Warrenville, IL)
    …inbound calls from AGWS Customers to assist with questions related to maintenance claims . You will assist customers by walking them through and helping them ... understand their contract in relation to their maintenance claim requests. Responsibilities will include, but are not limited to:- Reviewing automotive contracts and… more
    Reynolds & Reynolds (05/08/25)
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  • Compliance Associate

    Robert Half Finance & Accounting (Elmhurst, IL)
    …to regulations and policies, and will involve the use of various software systems to monitor business activities, maintain records, and aid in communication across ... departments. Job Description: * Utilize Sungard Protegent system for monitoring trading activity and real-time alerts. *...to ensure compliance. * Utilize CRM and ERP software systems to manage customer interactions and business resources. *… more
    Robert Half Finance & Accounting (06/19/25)
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  • Coding Auditor Educator

    Highmark Health (Springfield, IL)
    …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
    Highmark Health (05/09/25)
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  • Contractor Connect - Senior Resolution Manager

    Robert Half Legal (Chicago, IL)
    …Bachelor's Degree + Experience with multi-state claims handling + Familiarity with claims management systems and reporting tools Robert Half is the world's ... Description Workers' Compensation Claims Supervisor (Remote - NY Jurisdiction) Location: Remote (US - NY License Required) Industry: Insurance / Claims … more
    Robert Half Legal (07/31/25)
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  • Payor Contracts/Credentialing Analyst

    Option Care Health (Chicago, IL)
    …and distributes contract implementation materials with appropriate internal customers to ensure claims billing systems are set up correctly, and communication of ... schedules, basic contract terms, benefit type (medical, pharmacy, specialty pharmacy), medical claim denials, and pharmacy claim rejections. + Assists managing… more
    Option Care Health (07/25/25)
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  • Disability Business Procedures Consultant

    MetLife (Aurora, IL)
    …varied processes/products, Federal and State regulations, contracts and all disability claim management and correspondence systems . * Excellent written ... of non-standard process and/or correspondence requests including but not limited to claim operations, customer delivery and legal. Works with all parties to ensure… more
    MetLife (07/16/25)
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