- CVS Health (Springfield, IL)
- …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
- CVS Health (Springfield, IL)
- …and financial accuracy. **Required Qualifications** + 1-2+ years of experience in a quality audit or claims testing environment. + Working knowledge ... day. **Position Summary** The Senior Claim Benefit Specialist serves as a quality champion and...process improvements. + Participate in special projects and targeted quality audit initiatives. + Provide subject matter… more
- Axis (Chicago, IL)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores… more
- Sedgwick (Chicago, IL)
- …; ensures appropriate recommendations are made on claims . + Consistently achieves appropriate quality audit scores. + Acts as clinical resource to claims ... of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for… more
- ATI Physical Therapy (Downers Grove, IL)
- **Overview** In the Sr. Revenue Cycle Management (RCM) Specialist role, you will partner with business leaders to improve and deliver positive change throughout all ... the RCM Supervisor, RCM Sr. Mgr./Mgr. to review the quality , efficiency, and productivity of our vendor partners. The...and productivity of our vendor partners. The Sr. RCM Specialist will work to improve the accuracy and effectiveness… more
- Health Care Service Corporation (Chicago, IL)
- …in your professional development. **Job Summary** The Advanced Contract Specialist is responsible for developing master documents and/or account-specific financial ... processes, update provider demographic information, and pull contracts for legal, audit , and compliance purposes. **Required Job Qualifications:** + 4 years… more
- Elevance Health (Chicago, IL)
- …letters. + Maintains accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and documentation ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of...purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- Rush University Medical Center (Chicago, IL)
- …feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Exemplifies ... Bachelor's Degree * Certified Professional Coder (CPC) or Certified Coding Specialist - Physician Based (CCS-P) * Registered Health Information Administrator (RHIA)… more
- Elevance Health (Chicago, IL)
- …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise,...Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation… more
- International (Lisle, IL)
- …a few years to take on this strategic challenge or an experienced generalist or specialist within one of the TRATON brands with a strong track record and the ability ... March 2026 for the US site, including process documentation, gap analysis, audit readiness, and stakeholder alignment. + Support the adoption of performance… more