- Humana (Springfield, IL)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Centene Corporation (Springfield, IL)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality… more
- Fujifilm (Springfield, IL)
- …be an integral part of the legal team providing support to the Medical Device businesses of FUJIFILM Healthcare Americas Corporation and FUJIFILM SonoSite, Inc., ... (HLUS). The Senior Counsel, reporting to the Division General Counsel, Medical Devices, will be an experienced commercial transactions lawyer, responsible for… more
- Humana (Springfield, IL)
- …and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Humana (Springfield, IL)
- …Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The ... Medical Coding Coordinator performs advanced administrative, operational, and customer...apply intermediate mathematical skills. **Where you Come In** The Medical Coding Coordinator extracts clinical information from a variety… more
- Sedgwick (Springfield, IL)
- …as it relates to policy language and advises client of the outcome. + Handles medical claims (under P&I coverage) from beginning to end requesting medical ... Insurance Marine Investigator **PRIMARY PURPOSE** **:** To perform detailed admiralty claims investigation and analysis through examination of the loss, collection… more
- CVS Health (Springfield, IL)
- …**Position Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves ... metrics **Required Qualifications** + 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking… more
- Baylor Scott & White Health (Springfield, IL)
- …(Commercial, DTE, Medicare, and Medicaid). Candidate will oversee extracting and analyzing medical and pharmacy claims data, translating output into business ... **JOB SUMMARY** 100% remote position** The Medical Trend Analytics Manager 1 is responsible for...with excellent healthcare business acumen and communication skills. The Medical Trend Analytics Manager 1 manages a team that… more
- Amazon (IL)
- Description Application deadline: Dec 29, 2025 As a member of the Amazon One Medical Senior Health Revenue Cycle team, the Medical Coder I will be responsible ... for supporting Amazon One Medical Clinical and Revenue Cycle teams in reviewing the...Revenue Cycle teams in reviewing the coding accuracy of claims . This role reports into the Manager I, Revenue… more
- Sedgwick (Naperville, IL)
- …Insurance Service Center Specialist **PRIMARY PURPOSE** **:** To provide support to the claims staff and to perform other office tasks depending on the client ... FUNCTIONS and RESPONSIBILITIES** + Sets up and enters new claims into claims management system. + Inputs...forms. + Answers and initiates telephone calls, sets up medical appointments, and may provide customer service as required.… more