• Medical Director - Florida

    Humana (Springfield, IL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... focus on collaborative business relationships, value based care, population health , or disease or care management. Medical ...population health , or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal… more
    Humana (07/29/25)
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  • Medical Director - NorthEast Region

    Humana (Springfield, IL)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health more
    Humana (07/25/25)
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  • Claims Rep I ( Health & Dental)

    Elevance Health (Chicago, IL)
    …(word processing, spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. For candidates working in person ... ** Claims Representative I** **Location:** This role enables associates...: Illinois, Minnesota In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
    Elevance Health (08/29/25)
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  • Senior Liability Claims Adjuster

    CVS Health (Springfield, IL)
    …Qualifications** . 3+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance ... At CVS Health , we're building a world of health...5+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare… more
    CVS Health (08/24/25)
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  • Medical Director - Medicare Grievances…

    Humana (Springfield, IL)
    …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health more
    Humana (08/08/25)
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  • Medical Claims Processor - Remote

    Cognizant (Springfield, IL)
    …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document. **Role… more
    Cognizant (08/26/25)
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  • Medical Director - Medicare Grievances…

    Humana (Springfield, IL)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health more
    Humana (08/26/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Springfield, IL)
    …and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and ... hospital claims utilizing payer specific policies and procedures. Provide support...Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's plan document.… more
    Cognizant (08/01/25)
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  • Senior Claims Benefit Specialist

    CVS Health (Springfield, IL)
    …amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine ... At CVS Health , we're building a world of health...heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist** will review and adjust SF (… more
    CVS Health (08/31/25)
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  • Virtual Medical Biller/Coder - Patient…

    IQVIA (Chicago, IL)
    **Patient Support Medical Claims Processing ​ Representative** _Remote Role - Location (Open to Remote US)_ As the only global provider of commercial solutions, ... we are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team. In this position,… more
    IQVIA (08/21/25)
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