- Prime Therapeutics (Springfield, IL)
- …Thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical + Self learns new processes/software ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …and Risks will be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy and strategy and gain a ... develops systems for Clinical vendor management and vendor oversight. + **Management Review :** Establish and maintain a system to ensure R&D Management Reviews are… more
- R1 RCM (Chicago, IL)
- …to draft appeals of denied and underpaid claims . Every day you will review medical records to ensure appropriate coding of removed or revised diagnosis and ... review and interpret medical records...Coding Appeals Nurse:** + Review and interpret medical records to appeal denied and underpaid claims .… more
- AbbVie (Mettawa, IL)
- …innovation in scientific strategy and standards including Scientific Platform, CFL, SIUU, and Medical Review . + Lead the strategic redesign and implementation of ... promotional resources and driving process efficiencies. + Ensure consistent Medical Review onboarding and ongoing training /...capabilities (US Digital Lab & International) related to core claims and material review , to effectively scale… more
- Kemper (Chicago, IL)
- …SIU, Subrogation and outside vendors as required. **Position Responsibilities:** + Property claims handling including initial coverage review and contact of all ... evaluation, coverage determination, negotiation, and settlement of non-complex property contents claims . Ensures claims are handled within best practices and… more
- Marriott (Chicago, IL)
- …of property and parking areas. * Provides means for obtaining necessary medical attention on a timely basis. **Leading Security/Loss Prevention Teams** * Attends ... setting performance standards and monitoring performance. * Provides personal assistance, medical attention, emotional support, or other personal care to others such… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …and/or channel functions required + Performance tracking and quarterly business review development experience + Experience working in matrix management structure ... with states and local laws. **Company benefits** : Comprehensive medical , dental, vision, prescription drug coverage, company provided basic...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Transdev (Lombard, IL)
- …and 4 floating - Other standard benefits: 401(k) retirement plan, medical , dental and vision, life insurance, short-term disability, voluntary long-term disability. ... support for key internal topic of insurance and insured claims estimates + Work with actuary and risk department...preparation of financial reporting process and monthly financial reporting review package + Works on complex finance topics as… more
- R1 RCM (Chicago, IL)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... Denials Consultant, you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages of the… more
- Elevance Health (Chicago, IL)
- …with Jira, Confluence, Bamboo and qTest is a plus. + Health insurance and medical claims knowledge preferred. + Quality certification such as CMQ, CQA, CQPA, ... with Jira, Confluence, Bamboo and qTest is a plus. + Health insurance and medical claims knowledge preferred. **For candidates working in person or virtually in… more