- 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
- The Hartford (Naperville, IL)
- Team Leader Claims - CH08AE We're determined to make a...world? What else can we do to destigmatize mental health in the workplace? Can we make our communities ... our team as we help shape the future. The Claims Team Leader will manage and direct claim investigation,...and execution of the investigation, disposition and settlement of claims , in compliance with corporate claim standards and procedures,… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...requirements. + Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support. **Performance… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...**Position Summary** Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies… more
- CVS Health (Chicago, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers… more
- CVS Health (Chicago, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...internal staff that aligns PE/Network functions with Operations and Claims as needed + Research, review, and prepare responses… more