- Norstella (Springfield, IL)
- …interest in healthcare and technology, experience analyzing large databases, (such as claims , EMR, and lab data), expertise with applications of study design and ... common analytic methods for commercial analytics for brand launch/ management , field team targeting, healthcare research, patient outcomes, prescriber trends, and/or… more
- Sedgwick (Springfield, IL)
- …Executive General Adjuster - Midwest Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss...+ Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …and implementing procedures to ensure that the business units quality management and compliance program are effective and efficient in identifying, detecting, ... Systems and Risks will be reported periodically to Senior Management through the Management Review process to...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Prime Therapeutics (Springfield, IL)
- …including such items as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ ... cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract… more
- CVS Health (Springfield, IL)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... issues. May handle customer service inquiries and problems. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing… more
- Zurich NA (Chicago, IL)
- …Diploma or Equivalent and 10 or more years of experience in the Claims , Underwriting support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Elevance Health (Chicago, IL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... + Maintains accuracy and quality standards as established by audit management . + Identifies potential documentation and coding errors by recognizing aberrant… more
- Walgreens (Peoria, IL)
- …billing is completed and accurate prior to claim submission (ie, medical claims billing). + Process reimbursement checks/payment in accordance with policy. + Review ... price modify logs and ensure there are corresponding SDL (submit direct link) claims . + Review, research and resolve all third party chargebacks in a timely manner.… more
- Zurich NA (Chicago, IL)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Superior Ambulance Service (Elmhurst, IL)
- …our clients. Specific tasks include resolving insurance carrier denials, appealing claims , contacting carriers on open accounts and responding to insurance carrier ... in employee training with possible exposure to multiple practice management systems. This position is fully in-office Monday through...72 hours of receipt + Responsible for resolving unpaid claims that are Greater than 60 days from date… more