- Bowman (Springfield, IL)
- …by more senior staff to ensure application of sound techniques and principles. Review work produced by junior staff for quality assurance. **At the Operational and ... of values, various exhibits, partial and final liens. + Review , process, obtain approvals, code and accrue for subconsultant...that may arise as it relates to disputes, or claims + Act as liaison between operations and many… more
- Farnsworth Group (Champaign, IL)
- …water main/sewer, retaining walls, stormwater pollution prevention implementation, traffic control review and related facilities. A person in this position is ... requirements and restrictions. + Meet with contractors regularly to understand and review work plan and schedule, resolve issues in work areas, address scheduling… more
- Cardinal Health (Springfield, IL)
- …laws including, Antitrust; healthcare laws and regulations, (eg, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Demonstrate excellent ... business teams, including sales, marketing, operations and finance + Review marketing materials related to customer services and FDA...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Adecco US, Inc. (Springfield, IL)
- …Center. . Prioritize the privacy and confidentiality of the patient's medical information, adhering to HIPAA regulations, and organizational policies always. . ... Utilize prescription claims data to generate clinical recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review … more
- AbbVie (Mettawa, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... health outcomes research findings internally to AbbVie and externally via the peer- review process. In addition, the Manager builds research relationships with key… more
- Humana (Springfield, IL)
- …time frame. + CAS, MedHOK experience strongly preferred + Previous experience processing medical claims **Required Work Schedule** **This is a remote role and ... issues. manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or… more
- CVS Health (Springfield, IL)
- …Monitor service performance and implement improvements, as necessary. Gain in-depth knowledge of claims system and Call Tracking System to be able to lookup and ... in daily/weekly/monthly operational calls with client and internal operations to review and calibrate client service metrics and performance guarantees. Analyze data… more
- Intermountain Health (Springfield, IL)
- …Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases ... ICD-10 and Diagnosis Related Groups (DRG) codes for claims concurrently while a patient is in a hospital....reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and… more
- Robert Half Finance & Accounting (Elmhurst, IL)
- …range for this position is $80,000-$85,000 and it comes with benefits, including medical , vision, dental, life, and disability insurance. To apply to this hybrid ... keeping for swift response to inquiries or audits. * Contribute to the development, review , and upkeep of our Written Supervisory Procedures. * Foster a culture of… more
- 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...payments + Negotiate out-of-network reimbursement rates with insurances + Review of Accounts Receivable Aging reports + Meet daily,… more