- Elevance Health (Chicago, IL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- **Company Overview:** Otsuka is a global healthcare company driven by our purpose "to defy limitation, so that others can too." Patients are at the center of our ... purpose as we seek to discover and deliver innovative healthcare solutions. Otsuka is a leader in the CNS...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Prime Therapeutics (Springfield, IL)
- …in Microsoft Word, Excel, Project, PowerPoint, and Visio **Preferred Qualifications** + Rx Claims system proficiency + Previous PBM or healthcare experience + ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more
- Cognizant (Springfield, IL)
- …have strong technical skills in MS Excel and preferably experience in IVR and Healthcare Call Center domains. This is a work-from-home position with day shifts and ... no travel is required. The role involves managing and optimizing healthcare processes to improve efficiency and patient satisfaction. **Responsibilities:** Reviewing… more
- Ankura (Chicago, IL)
- …excellence founded on innovation and growth. Ankura's Global Disputes and Economics Healthcare and Life Sciences Practice is searching for a talented individual to ... firms in the United States. Ankura's Disputes and Economics Healthcare and Life Sciences Practice is the largest industry...in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act;… more
- R1 RCM (Chicago, IL)
- …answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims . To thrive in this role, you must be resourceful and have ... Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission...+ Minimum of 1 year of experience in the Healthcare Revenue Cycle (Cash posting, Billing, Follow Up) is… more
- Walgreens (Deerfield, IL)
- …for verifying patient eligibility, coordinating benefits, running test claims , and determining patient coverage/responsibility for services. Handles inbound ... reviews FDA guidelines, and prior authorization requirements to ensure payment of claims . + Resolves questions and problems submitted by customers and Major Medical… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …Competencies** **K** **nowledge** - Experience working in the pharmaceutical and/or healthcare industry. - Knowledge and experience with preparation of global ... clinical development, project management, quality assurance, etc.) in pharmaceutical or healthcare related industry. Experience with FDA or other health authority… more
- Humana (Springfield, IL)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- Walmart (Quincy, IL)
- …** It's time to see optometry through a new lens. Walmart is revolutionizing healthcare and this your chance to be part of it. A Walmart Associate Optometrist ... patients with appropriate referrals, as needed, to ophthalmologists and other healthcare professionals; and following up with patient and other health professionals… more