• Appeals Nurse Reviewer I

    Elevance Health (Chicago, IL)
    ** Appeals Nurse Reviewer I**...Outreach to providers with appeal process instructions. + Clinical review for the RBM and Surgical solution on a ... set of clinical domains, including radiology, cardiology and oncology. The ** Appeals Nurse Reviewer I** is responsible for conducting preauthorization, out… more
    Elevance Health (09/26/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Springfield, IL)
    …drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral ... and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings and consults with...Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… more
    Prime Therapeutics (10/04/25)
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  • Customer Service Representative

    CVS Health (IL)
    …in accordance with contract. Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) ... Aetna's Law Document Center regarding litigation; lawsuits. Handles extensive file review requests. Assists in preparation of complaint trend reports. Assists in… more
    CVS Health (09/26/25)
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