• Pharmacy Claims Auditor CPhT

    Conduent (Chicago, IL)
    …part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like to ... audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
    Conduent (04/18/25)
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  • Stat/PFL Claims Specialist

    Lincoln Financial (Springfield, IL)
    …Role at a Glance** We are excited to bring on highly motivated STAT / PFL Claims Specialists to staff our ever-growing claims organization. As a STAT / PFL ... initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations....diploma or GED + 1-2 years of experience in claims , leaves or customer service + Strong written and… more
    Lincoln Financial (05/31/25)
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  • Disability Claims Specialist

    Caterpillar, Inc. (Peoria, IL)
    …interacting with consultants and internal partners. **What You Have** + Basic medical understanding along with claims experience to intelligently discuss ... in it. **Role Definition** The objective of the Disability Claims Specialist provides Total Rewards support to internal customers...guidelines. This is a summary list of benefits. + Medical , dental, and vision benefits* + Paid time off… more
    Caterpillar, Inc. (05/28/25)
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  • Claims Adjuster - Automotive

    Reynolds & Reynolds (Warrenville, IL)
    …between work and family. We offer a comprehensive benefits package including: - Medical , dental, vision, life insurance, and a health savings account- 401(k) ... Warranty Services, Inc. (AGWS), an affiliate of Reynolds and Reynolds, is seeking a Claims Adjuster - Automotive for our growing team at our office in Naperville,… more
    Reynolds & Reynolds (05/16/25)
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  • P&C Senior Director - Pricing, Product,…

    WTW (Chicago, IL)
    …benefit package which includes the following (eligibility requirements apply): + ** Health and Welfare Benefits:** Medical (including prescription coverage), ... America P&C propositions, especially in the business-focused areas of Pricing, Product, Claims and Underwriting. Our goal is to substantially increase our footprint… more
    WTW (05/09/25)
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  • Claims Business Analyst - Remote

    Cognizant (Springfield, IL)
    …or requested; and other duties as assigned. Maintain and particpate in all Mass Health forums to understand, translate and implement Mass Health guidelines to ... and in a team environment + Extensive knowledge of Massachusettes Medicaid Mass Health laws required + Experience with Mass Health governing policies and… more
    Cognizant (05/20/25)
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  • Senior Data & Analytics Liaison

    AbbVie (North Chicago, IL)
    …with pharmaceuticals industry specific datasets - Clinical Trials, Safety, Regulatory Affairs, Medical Affairs, Health Records, Claims , R&D finance and ... and deliver innovative medicines and solutions that solve serious health issues today and address the medical ...serious health issues today and address the medical challenges of tomorrow. We strive to have a… more
    AbbVie (04/26/25)
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  • Medical Director - Behavioral Health

    CVS Health (Springfield, IL)
    …position and can be based anywhere in the United States.** ** The Behavioral Health (BH) Medical Director (Special Investigations Unit) will be responsible for ... At CVS Health , we're building a world of health around...performing reviews of BH medical records and/or CPT code/HCPCS codes of known or suspected acts… more
    CVS Health (05/31/25)
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  • Clinical Risk Manager RN

    Rush University Medical Center (Chicago, IL)
    …Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: RUSH Risk & Claims Management **Work Type:** Full ... management and overseeing loss control activities for Rush University Medical Center, Johnston R. Bowman Health Center...claims handling pursuant to the terms of the Medical Center's Self Insurance Program. Exemplifies the Rush mission,… more
    Rush University Medical Center (05/24/25)
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  • DRG Coding Auditor

    Elevance Health (Chicago, IL)
    …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... may be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
    Elevance Health (05/29/25)
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