- CVS Health (Springfield, IL)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the... processing changes + Ensure daily reconciliation of electronic claim files + Maintain productivity and quality standards of… more
- Walgreens (Waukegan, IL)
- …+ Ensure all required documentation for billing is completed and accurate prior to claim submission (ie, medical claims billing). + Process reimbursement ... experience with Walgreens. + Experience in processes related to submitting medical claims , including but not limited to Medicare submission, knowledgeable in EOB… more
- Humana (Springfield, IL)
- …in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary, Analytics/Forecasting ensures data integrity ... community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to… more
- Sedgwick (Chicago, IL)
- …payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- CVS Health (Springfield, IL)
- …review a clinical determination and understand rationale for decision. + Able to research claim processing logic and various systems to verify accuracy of claim ... efforts both internally and across departments to successfully resolve claims research, SPD/COC interpretation, letter content, state or federal regulatory… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse** to work from our Schaumburg, IL office. ... With limited direction, reviews highly complex medical billing, including more difficult medical jurisdictions,...and resolve issues by working with corporate law, Technical Claims and other, as necessary. + Prepare, attend and… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- The Manager, Medical Core Content is a team-level operational role responsible for the development, maintenance, and day-to-day quality assurance of all core ... scientific and medical content for the relevant therapeutic area. This role...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of Medical ... internal priorities, this individual will shape the development of best-in-class medical excellence capabilities aligned with Otsuka's vision, direction, and growth… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- The Director, Strategic Planning & Operations is a pivotal role within the Medical Excellence & Operations team within Global Medical Affairs. This role is ... responsible for overseeing 3 medical business unit specific Strategic Planning roles (CNS, Nephrology...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- The Senior Director, Medical Communications, CNS directs and provides strategic leadership for the global and US scientific communication strategy for the assigned ... directing the development and dissemination of all core scientific and medical content (eg, global slide decks, congress abstracts/presentations, publications, … more