- Highmark Health (Springfield, IL)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... governmental agencies. These studies and projects may involve all aspects of the health insurance business and care management processes and may be confidential in… more
- Sedgwick (Springfield, IL)
- …evaluates, negotiates, and resolves recreational marine or personal watercraft claims internationally, regardless of complexity and quantum. **ESSENTIAL FUNCTIONS ... and RESPONSIBILITIES** + Investigates recreational marine or personal watercraft claims thoroughly using technical expertise and complex analysis. + Examines… more
- Highmark Health (Springfield, IL)
- **Company :** Highmark Health **Job Description :** The Graduate Intern - Data Analytics will work closely with Senior Data Scientists to support Highmark's Fraud, ... Daily responsibilities will involve the in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect anomalous provider… more
- AON (IL)
- …is responsible for maintaining and enhancing the DXC SICS (Swiss Insurance Claims System) application to support business processes in reinsurance and insurance ... claims management. The role involves configuring the application, troubleshooting...sick leave laws, short-term disability and optional long-term disability, health savings account, health care and dependent… more
- Nestle (Schaumburg, IL)
- …needs to support the factory **POSITION SUMMARY:** Reporting to the Safety, Health and Environmental Manager, the Occupational Health & Wellness Specialist ... is entrusted to support factory safety activities, work to improve overall employee health and wellness, and promote the health and safety of the employees in… more
- Humana (Springfield, IL)
- …care or managed care experience working with providers (eg, provider relations, claims education). + Experience working with physical health providers, ... **Become a part of our caring community and help us put health first** Humana Gold Plus Integrated is seeking Provider Engagement Professionals (LTSS) who are… more
- Elevance Health (Chicago, IL)
- …by law._ **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Health Care Service Corporation (Chicago, IL)
- …impact for our customers and members. At the largest customer-owned and not-for-profit health insurer and fourth largest health insurer overall in the United ... (or thematic units) within AI Solutions, with topics that include Claims and Payment Integrity, Member Engagement, Utilization Management, Document Intelligence,… more
- Health Care Service Corporation (Chicago, IL)
- …business analysis, process improvement,** project management, business operations or relevant health care industry experience * 3 years of experience leading with ... + . Provider Credentialing - sCRED application + . Claims Intake process + . Claims Adjudication...* Agile tool such as Jira/Rally * SQL * Health insurance or healthcare industry experience with emphasis on… more
- Carle Health (Urbana, IL)
- …improve revenue cycle activities for prior authorizations, documentation, billing and claims . Understands regulatory and third party payer guidelines for admissions, ... healthcare trends in authorization, insurance verification and benefits, reimbursement, claims denials, and hospital/clinical management + Identifies, discusses, plans… more