- Highmark Health (Springfield, IL)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have ... understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed oriented… more
- Humana (Springfield, IL)
- …Analytics + Experience with Power BI report builder + Experience analyzing medical claims or health care provider contracting **Additional Information** + As part of ... our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location… more
- Edwards Lifesciences (Naperville, IL)
- …+ Understanding of medical device asset creation, regulation requirements for claims and training content creation/updates + Demonstrated ability to direct teams ... and provide coaching and feedback. + Ability to interact professionally with all organizational levels and proactively escalate issues to appropriate levels of management in the organization + Ability to work and excel within a fast paced, dynamic, and… more
- Highmark Health (Springfield, IL)
- …of experience in Provider Data Management, Credentialing, Customer Services or Claims . **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + None ... **SKILLS** + Ability to communicate with both providers and customers + Microsoft Office + Typing/Computer Proficiency + Problem Solving Skills **Language (Other than English)** None **Travel Requirements** None **Position Type** Office-based Teaches / trains… more
- Humana (Springfield, IL)
- …Information Technology, Enrollment, Member Services, Grievance and Appeals, Claims , Encounters, Program Integrity and Subcontractor Management. Key responsibilities ... include: + Research and assess prospective new markets. Gather key information on market and regulatory landscape and translate state policy to discern impacts to Humana's operating model. + Coordinate operational teams to translate contract requirements,… more
- ABM Industries (Chicago, IL)
- …coordinates bus evacuation activities as appropriate * Immediately reports any incidents or claims to Operations Manager or Shift Lead * Refuel and maintain shuttle ... equipment and fuel use logs * Maintain a clean work environment, disinfecting shuttle after each use * Performs pre-inspection and post-inspection activities to ensure proper operating conditions, adherence to prescribed Department of Transportation standards,… more
- Humana (Springfield, IL)
- …record reviews + Assess discharge plans + Review and extract information from claims + Complete documentation for Quality Reviews for Peer Reviews + Discuss cases ... with Medical Directors + Work in partnership with other members of the Humana Interdisciplinary team + Comply with performance and reporting standards as defined by Humana + Complete additional responsibilities as deemed appropriate by Humana leadership + Our… more
- Humana (Springfield, IL)
- …Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming ... + Represents Humana at all Pharmacy Medicaid meetings including those with the Illinois Department of Healthcare and Family Services (HFS) **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in pharmacy or Doctor of Pharmacy… more
- Walmart (Cicero, IL)
- …area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up, ... cleaning, and organizing product displays; removing damaged goods; signing and pricing merchandise appropriately; completing required audits, paperwork, logs, and other required documentation; and securing fragile and high-shrink merchandise. Provides Member… more
- Path Construction (Chicago, IL)
- …projects + Project scheduling, including pre-construction activities + Oversight of project claims and resolution + Oversee and facilitate purchasing and issuance of ... subcontracts and purchase orders. + Manage project controls for safety, quality, owner relations, and profitability Requirements Division Managers must have the following experience and be proficient in the use and execution of the following systems: + 10+… more