- AbbVie (Mettawa, IL)
- …benefit managers (PBMs), Group Purchasing Organizations (GPOs) + Experience analyzing patient claims data (eg IQVIA LAAD, Symphony Health data) for Pharmacy channel ... products. Expert level knowledge of tools like PowerBI to extract/ analyze data and communicate a story through insights + Ability to develop insights and communicate effectively to cross-functional business partners, in both oral and written form Programming… more
- Blessing Hospital (Quincy, IL)
- …safe practices, improving quality care and services we deliver, loss prevention, claims avoidance, litigation defense, and the overall protection of the health ... system's assets. This position requires full understanding and active participation in fulfilling the Mission and Vision of the Blessing Health system. It is expected that the employee demonstrates behaviors consistent with the Core Values and ICARE standards… more
- GE HealthCare (Chicago, IL)
- …and approves advertising and promotion material to ensure consistency with approved claims and regulatory requirements. + Is an active member of external industry ... trade associations and/or standards organization and/or other relevant external groups to help shape regulatory requirements. + Proven interpersonal skills. Communication with direct colleagues and the business about design and coordination services rendered.… more
- Sysco (Chicago, IL)
- …delivery impacts. + Communicate daily with Director of Transportation, Claims Coordinator, and Transportation Supervisors, Transportation Leads, and Transportation ... Operations Associates (TOAs) concerning shipping activities. + Communicate daily with warehouse operations teams and RDC carriers to facilitate efficient production levels and yard operations. + Oversee, hire, train, develop, evaluate and maintain discipline… more
- Sedgwick (Chicago, IL)
- …from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional ... professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability...with a comprehensive curriculum. + An assigned mentor and manager that will support and guide you on your… more
- Travelers Insurance Company (Downers Grove, IL)
- …reserving, negotiating and resolving assigned General Liability - Public Sector claims . Provides quality claim handling throughout the claim life cycle (customer ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures file...facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed.… more
- Travelers Insurance Company (Chicago, IL)
- …Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as expense accounts, time off reporting, etc. ... this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim… more
- Humana (Springfield, IL)
- …and LTSS) roles and responsibilities include: + Serve as primary relationship manager with assigned providers to ensure positive provider experience with Humana's ... including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals). + Work with internal… more
- Rising Medical Solutions (Chicago, IL)
- …- CNA, Medical Assistant, Physical Therapy Aide, Workers' Compensation, Medical Unit Claims Administrator, IME Coordinator, Medical Office Manager + Experience ... and schedule appointments as needed, and keep the Telephonic Nurse Case Manager (TCM), clients, claimants, providers, and employers informed verbally and/or in… more
- Molina Healthcare (Chicago, IL)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more