- Cognizant (Springfield, IL)
- …the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member ... accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and… more
- IQVIA (Chicago, IL)
- …HIPAA certified + Call center experience required (3+ years preferred) + Experience in medical claim processing is a plus + Bi-lingual (English/Spanish) is a ... what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need… more
- Pearle Vision (Schaumburg, IL)
- …practice. Their duties may include the utilization of computerized medical office software, administrative office procedures, health insurance processing billing ... and transcription of medical reports. An Optometric Office Technician role may combine...for priority patients * Scheduling appointments * Processing insurance claim forms * Patient and insurance billing * Optometric… more
- Veterans Affairs, Veterans Health Administration (Marion, IL)
- …EDRP application. Former EDRP participants ineligible to apply. The Marion VA Medical Center is seeking a part-time Gastroenterology Physician to join their ... shall be expected to cooperate with and participate in medical duties or functions related to quality of care,...claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm… more
- CVS Health (Springfield, IL)
- …in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.… more
- ProSmile (Oak Park, IL)
- …Responsibilities The duties include, but are not limited to: + Audit charts + Submit claims + Enter insurance payments + Follow up on outstanding claims and ... week) and Part Time Benefits Eligible Positions (30-35 hours per week): + Medical Insurance: Choice of five comprehensive Aetna medical plans, including options… more
- CVS Health (Buffalo Grove, IL)
- …do it all with heart, each and every day. **Position Summary** The Oncology/ Medical Specialty Clinical Development Sr. Manager will be responsible for overseeing the ... interventions including prior authorization, step therapy, quantity limits, and Oncology and medical Specialty drug UM processes is required. The leader will feel… more
- Veterans Affairs, Veterans Health Administration (Mount Vernon, IL)
- …residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR [(2) Those approved by the American Osteopathic ... verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the...claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm… more
- Walmart (Freeport, IL)
- …to ensure proper diagnosis and treatment by reviewing complete patient medical history information and performing comprehensive eye examinations; examining eyes ... using evidence-based care guidelines and patient preferences; referring patients with medical conditions outside of vision care services to appropriate community… more
- CVS Health (Springfield, IL)
- …members and self-funded clients. + Monitors performance of high dollar specialty claims . + Research and outreach on appropriate interchanges of medications from the ... medical to pharmacy benefit. + Help triage escalated, high-touch member claims issues and service concerns. + Performs outbound communication, and proactive… more