- Highmark Health (Springfield, IL)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the … more
- AON (Chicago, IL)
- …Executive Summaries of the workbooks for presentation to clients. + Assist the claim preparation team in complex property damage and business interruption loss ... claim preparation and substantiation on behalf of insureds Skills...Power BI). Specifically: + Cross-sell other CPAV services including Claims Preparation and Rapid Response. + Develop a rapport… more
- Rush University Medical Center (Chicago, IL)
- …to identify claim denials and develop appeal strategies. + Rebilling claims and processing adjustments or refunds as needed. + Maintain patient confidentiality ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: HB Govt… more
- Sedgwick (Chicago, IL)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... your 2+ years' experience in a office setting or medical experience and grow with us! + A stable...professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability… more
- Sedgwick (Chicago, IL)
- …time frames, and claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Highmark Health (Springfield, IL)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES** +… more
- UNUM (Springfield, IL)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- Elevance Health (Chicago, IL)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... -expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
- Robert Half Accountemps (Des Plaines, IL)
- … billing and coding within a healthcare setting. * Strong knowledge of medical claims submission and collections processes. * Familiarity with Epaces and ... Description We are looking for a skilled Medical Billing Specialist to join our team on...role, you will handle essential billing operations, ensuring accurate claims submissions and resolving unpaid claims with… more
- Sedgwick (Springfield, IL)
- …**:** To supervise the activities of the adjuster department; to assign caseload of claims to adjusters and to ensure customer satisfaction of claims services ... + Develops standards, programs, processes, and initiatives to assure quality claim files and results. + Resolves complaints and problems which have… more