- CVS Health (Buffalo Grove, IL)
- …Linux OS, GCP/ AWS/ Azure + Experience working with medical and/or pharmacy claims data + Experience in healthcare industry, including health insurance, PBM ... with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Walgreens (Deerfield, IL)
- …and Audits, Prescriber and prescriptive authority tickets, proper processing of prescription claims including order of claims processing for government payers. ... problems and questions regarding third party prescription plans from stores, claims processors, Walgreens Direct Bill contracts and other applicable parties.… more
- Humana (Springfield, IL)
- …and grows positive, long-term relationships with physicians, providers and healthcare systems. The Provider Engagement Professional (Physician and LTSS) roles ... including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals). + Work with internal… more
- Walgreens (Deerfield, IL)
- …support, direction, and documentation to assist in prioritization and managing potential claims and provide a cost effective outcome by focusing on the customer ... and collaborates with internal stakeholders in managing the intake of claims /liability inquiries about services including sending information of high exposure… more
- Elevance Health (Chicago, IL)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Evolent (Springfield, IL)
- …+ Ability to solve novel problems in creative ways is preferred + Previous healthcare experience with a focus in claims and prior authorization data is ... preferred **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to… more
- R1 RCM (Chicago, IL)
- …As our Denials & AR Analyst I, you will help R1 clients by analyzing claims information so that they can resolve complex accounts. Every day, you will conduct root ... Prior Denials or AR experience in Hospital or Physician claims and experience working in a production-based environment is...job-related skills, experience, and relevant education or training. The healthcare system is always evolving - and it's up… more
- Prime Therapeutics (Springfield, IL)
- …to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT ... and serve as subject matter expert and mentor for other members of Claims IT team, including cross-training assigned BSAs on system requirements phase of assigned… more
- Sharecare (Springfield, IL)
- …2-yr associates degree in healthcare /health sciences OR equivalent experience in healthcare , preferably helping members navigate benefits and claims , OR held ... through personalized resource and referral facilitation, issue resolution and healthcare navigation. Utilizing motivational interviewing and guided approaches, the… more
- Owens & Minor (Downers Grove, IL)
- At Owens & Minor, we are a critical part of the healthcare process. As a Fortune 500 company with 350+ facilities across the US and 22,000 teammates in over 90 ... Our mission is to empower our customers to advance healthcare , and our success starts with our teammates. Owens...Rx's, PA's and medical justification to facilitate payment of claims for initial and review/appeals payments. + Ability to… more