- Elevance Health (Chicago, IL)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...document determinations and continue to next step in the claims lifecycle. + Researches new healthcare related questions as… more
- Sedgwick (Springfield, IL)
- …Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- CVS Health (Springfield, IL)
- …experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and ... time management skills and ability to handle a full docket of litigated claims . - Strong written and verbal communication skills, ability to summarize complex issues… more
- Sedgwick (Springfield, IL)
- …support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- R1 RCM (Chicago, IL)
- …answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims . To thrive in this role, you must be resourceful and having ... pertaining to the EOB + Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission + Works with HIM and… more
- Aldridge (Libertyville, IL)
- …orders, and other related agreements. You will help manage and strategize construction claims and litigation and be responsible for overseeing claims and legal ... these capabilities across the organization. + Manage labor and employee relations claims as needed. + Manage outside counsel on litigation matters as needed.… more
- Conagra (Chicago, IL)
- …particular focus on those that overlap with support activities (eg, regulated label claims , product attribute claims ). + Provide support as needed on ... technical information to support product safety determinations and product claims substantiation. + Demonstrated ability to work collaboratively, think critically,… more
- Sedgwick (Springfield, IL)
- …locations/offices; provides expert medical and product support to Sedgwick claims and clinical staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Amgen (IL)
- …with analytics focused on Patient Services and Market Access** , including claims analysis, hub data tracking, affordability program utilization, and payer trend ... , ensuring data accuracy from sources such as specialty pharmacies, claims aggregators, and market research providers. + Participate in the **development… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more