- Humana (Springfield, IL)
- …Eligible (HMO D-SNP) in IL, is seeking a Claims Research & Resolution Professional claims educator, who will be responsible for carrying out Humana's ... claims denials through claims education and training. The Claim Research and Resolution Professional reports to the Claims Research and… more
- Zurich NA (Schaumburg, IL)
- Claims Shared Services Support II 126107 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to ... your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct… more
- Intermountain Health (Springfield, IL)
- …Provides extraordinary care to our customers through friendly, courteous, and professional service through a broad understanding of account handling processes, ... payments to patient accounts, using both electronic and manual posting systems + Research , validate and make adjustments to payment postings. Follow up in accordance… more
- Travelers Insurance Company (Downers Grove, IL)
- …or their legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation plan with staff ... reserving, negotiating and resolving assigned General Liability - Public Sector claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Humana (Springfield, IL)
- …determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from ... and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more
- CVS Health (Downers Grove, IL)
- …as well as for internal staff that aligns PE/Network functions with Operations and Claims as needed + Research , review, and prepare responses for all ... communications including newsletters, notifications, and Fax Blasts. + Issue Resolution : Address provider challenges proactively and implement solutions to improve… more
- Amgen (Chicago, IL)
- …insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate offices using approved materials + ... you'll help make a lasting impact on the lives of patients as we research , manufacture, and deliver innovative medicines to help people live longer, fuller happier… more
- Cardinal Health (Springfield, IL)
- …* Handle all escalations based upon region and ensure proper communication of the resolution within required timeframe agreed upon by the client * Serve as a liaison ... team with call overflow and intake when needed * As needed conduct research associated with issues regarding the payer, physician's office, and pharmacy to resolve… more
- Cardinal Health (Springfield, IL)
- …and ICD-10 codes by analyzing patient medical records. + Availability to assist with research of denied claims . + Maintains a functional knowledge of enterprise ... manages audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and… more
- BMO Financial Group (Evergreen Park, IL)
- …consistently across employees in the group; identifies scheduling conflicts for resolution . + Coordinates training requirements for staff ( research , booking, ... administrative and clerical tasks, financial and human resources administration and provides professional support to one or more Managers and their direct reports.… more
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