- Spectrum Billing Solutions (Skokie, IL)
- …+ Research and resolve insurance denials + File appeals on denied or underpaid claims + Check claim status on appropriate payor systems and contact insurances ... as needed + Send Medical Records and other documentation to payors as requested...Understanding of insurance benefits and reimbursement + Proficient in medical terminology, HIPAA and other critical governmental regulations +… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and… more
- Robert Half Legal (Chicago, IL)
- …to support claims . + Request and manage itemized bills and medical records from healthcare providers. + Maintain accurate records and ensure compliance with ... + Communicate effectively with clients, insurance adjusters, opposing counsel, and medical providers to facilitate case progress. + Coordinate with insurance… more
- CVS Health (Springfield, IL)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical ... 2+ years of experience working with diagnosis codes and medical terminology. + Moderate to advanced knowledge of Excel...and decision making skills + College degree preferred + Claims experience + DG system experience **Education** + High… more
- TORKLAW (Chicago, IL)
- …Damage Claim Resolution: Navigate the complexities of property damage claims , ensuring just and timely resolutions. + Lien Negotiation: Engage in strategic ... and clients. In this role, you'll work closely with clients, insurance adjusters, medical providers, and our legal team to ensure cases move smoothly and… more
- Carle Health (Champaign, IL)
- …coding and encoders as a means to ensure compliant billing of Carle claims . HIM Certified Coder is responsible for understanding and applying all regulatory coding ... billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications Certifications: Certified… more
- Rising Medical Solutions (Chicago, IL)
- …a plus - CNA, Medical Assistant, Physical Therapy Aide, Workers' Compensation, Medical Unit Claims Administrator, IME Coordinator, Medical Office Manager ... initiate appropriate verbal and/or written contacts with employers, clients, claimants, and medical providers. + Set up files in all appropriate systems; assign… more
- Datavant (Springfield, IL)
- …timely and compliant claim processing.** **What You Will Do:** + Review medical records and assign precise codes to ensure accurate coding aligned with client ... to make a significant impact in the field of medical coding. You will provide essential consulting services and...service outcomes in both hospitals and alternative care settings. ** Claim edit experience is required; Must be proficient in… more
- CVS Health (Buffalo Grove, IL)
- …and every day. **Position Summary** The Clinical Pharmacist engages within the Medical Affairs - Medicare Formulary Administration team to support the creation and ... Care, drug file and adjudication - Experience working with RxClaim and claims adjudication - Knowledge of regulatory environment and applicable standards - Excellent… more
- CVS Health (Springfield, IL)
- …implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and to help facilitate the member's overall ... including co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case management plan. -… more