- ChenMed (Berwyn, IL)
- …filing system updated for multiple procedures/processes. + Assists with pharmacy claims adjudication including calling insurances to assess and correct pharmacy ... claims rejections if appropriate. + Other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of ChenMed… more
- CVS Health (Springfield, IL)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team. To be successful in this role,… more
- Elevance Health (Chicago, IL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Humana (Springfield, IL)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Progress Rail Services Corp. (Lagrange, IL)
- …Significant independent judgment is used, but some direct guidance received from supervisor/ manager ; * Adhere to all Company, Department, and Workgroup policies and ... and/or field service team with summaries of findings as they relate to warranty claims ; * Monitors and audits reports to assure accuracy; * Act as warranty analyst… more
- Ankura (Chicago, IL)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... . Be a key contributor to project delivery teams . Serve as project manager for client services, including large and complex engagements . Support expert witness… more
- CDM Smith (Springfield, IL)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- US Tech Solutions (North Chicago, IL)
- …findings, and determine and document the conclusion(s). + Assist Supervisors and Manager in monitoring complaint and claims workflow to ensure compliance ... FDA and international Competent Authorities. + In addition will process claims for financial **reimbursement and replacement products** in accordance with… more
- Zurich NA (Chicago, IL)
- …will be filled at either the level I or Level II and the hiring manager will determine the appropriate level based upon the selected applicant's experience and skill ... and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s… more
- ProSmile (Oak Park, IL)
- …Dental Billing Specialist Department/Location: Operations Reports to: Dental Billing Manager FLSA Status: Non-Exempt Direct Reports: No Company Overview ProSmile ... are not limited to: + Audit charts + Submit claims + Enter insurance payments + Follow up on...+ Enter insurance payments + Follow up on outstanding claims and patient balances + Address patient balances +… more