- The Robison Group (Springfield, IL)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... background checks, and other investigative tasks. The majority of cases worked in this position require stationary and mobile surveillance. PRINCIPAL RESPONSIBILITIES FOR SURVEILLANCE: + Thoroughly complete assigned cases. + Testify to the collected facts… more
- Zurich NA (Springfield, IL)
- …rewarding career in commercial insurance. Remotely Apprentices will support our **F&I Claims Shared Services Team** with: + Engaging with both internal business ... Protection (GAP) coverage. + Sorting and routing incoming GAP mail to appropriate claims teams, updating files as required. + Monitoring and managing the Vehicle… more
- Walmart (Quincy, IL)
- …aligned with company and regulatory standards for prescriptions and claims , doctor and optician certifications/licensure, and associate training. Guides associates ... aligned with company and regulatory standards for prescriptions and claims , doctor and optician certifications/licensure, and associate training. Guides associates… more
- R1 RCM (Chicago, IL)
- …help review and interpret medical records to draft appeals of denied and underpaid claims . Every day you will review medical records to ensure appropriate coding of ... Nurse:** + Review and interpret medical records to appeal denied and underpaid claims . + Apply clinical judgment and knowledge for DRG downgrades performed because… more
- Elevance Health (Chicago, IL)
- …analysis; and reporting of statistical results. + Analyze health care data, including claims , clinical data, national survey data, and other large datasets using R ... preferred. + Experience with health plan administrative databases (pharmacy and medical claims ) and/or other big datasets is preferred. For candidates working in… more
- Evolent (Springfield, IL)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Highmark Health (Springfield, IL)
- …leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights ... to prototype. + **Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or standards (eg, SNOMED CT,… more
- Walgreens (Peoria, IL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Evolent (Springfield, IL)
- …accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based care, and the levers to optimize financial ... be leveraged to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data and insights… more
- Philadelphia Insurance Companies (Chicago, IL)
- …control technical support to Tokio Marine departments such as underwriting, claims and coordination. Coordinate loss control activities on select accounts ensuring ... and completed, responding to customer requests and needs and supporting underwriting and claims at renewal and during the policy period. Essential Job Functions: +… more