- Reyes Holdings (Rosemont, IL)
- …and provides guidance to team on short term disability/FMLA and Workers compensation claims , while updating all medical panels for panel states in workers' ... case managers and leave specialists + Evaluates vendors that provide medical management services for work or non-work-related injuries/illnesses. Recommends new… more
- Highmark Health (Springfield, IL)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... audit activities. Reviews medical records to determine data quality and accuracy of...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more
- Sedgwick (Naperville, IL)
- …General Adjuster - Midwest Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- CVS Health (Northbrook, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ... insurance companies. The SS&C team conducts descriptive research, medical chart review validations, and pragmatic research using the… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...exposure to benefits and/or contract interpretation, including experience with claims systems and network databases. + 3-5 years of… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...advocate for themselves. The TOC team will review prior claims to address potential impact on current case management… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...customers in understanding components of the Aetna products including claims , accumulators, usage and balances, and cost sharing. +… more
- CVS Health (Springfield, IL)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...claim processing and customer service that impact customer satisfaction, medical cost management, and operational efficiency. Consults cross-functionally with… more
- Guidehouse (Chicago, IL)
- …and value sets, such as ICD-10, DRG, and CPT + Experience with commercial health datasets, eg, claims , encounters, risk scoring, HEDIS measures, etc. + Knowledge ... Trust **What You Will Do** **:** As an AI/ML Health Data Science Senior Consultant with Guidehouse you will...creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and… more
- ADM (Chicago, IL)
- …**Job Title:** Senior Director of Regulatory & Scientific Affairs, Health & Wellness **Department/Function:** Research & Development **Job Description:** **Senior ... Director, Regulatory and Scientific Affairs, Health & Wellness - Chicago, IL; Decatur, IL; Kennesaw,...according to business priorities for product stewardship, market entry, claims , and maintenance of the regulatory aspects of the… more