- The Hartford (Naperville, IL)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... execute file strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim settlement… more
- Axis (Chicago, IL)
- …identity or expression, national origin or ancestry, citizenship, physical or mental disability , age, marital status, civil union status, family or parental status, ... taking part in the selection process. **Job Description** AXIS is seeking a **Senior Claims Specialist** to join our North America Claims team reporting to the… more
- Axis (Chicago, IL)
- …identity or expression, national origin or ancestry, citizenship, physical or mental disability , age, marital status, civil union status, family or parental status, ... part in the selection process. **Job Description** AXIS is seeking a **_Senior Claims Specialist - Environmental Claims_** to join our North America Claims .… more
- CVS Health (Springfield, IL)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Cognizant (Springfield, IL)
- **Healthcare Accounts Receivables - Claims Denials (remote)** Cognizant is one of the world's leading professional services companies, we help our clients modernize ... successful candidate performs advanced level work related to resolution of physician claim denials. This position will be responsible for root cause analysis… 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 ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- CVS Health (Springfield, IL)
- …availability and subject to change from working hours.** Inspects and provides accurate claim information to support savings optimization for claims . Responds to ... policies and procedures for medical cost management. Coordinates support functions for claim adjudication. **What you will do** + Executes both routine and… more
- Prime Therapeutics (Springfield, IL)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Claim Technical Analyst - JUDI Ops Team - Remote **Job Description** The Claims ... Technical Analyst is responsible for serving as the claims analysis resource for an assigned operations team. This role is responsible for developing queries to… more
- CVS Health (Springfield, IL)
- …Summary** **Position Summary** Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and ... staff for review. -Organized and prioritizes work to meet regulatory and claim turn-around times -Promotes communication, both internally and externally to enhance… more
- Sedgwick (Springfield, IL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to… more