Healthcare Payment Specialists Jobs in Illinois

... help empower results for our healthcare clients by delivering innovative and ... effective and productive relationships with healthcare clients and serves independently in ... accurate flow of information between..

... solutions as part of our Healthcare Industry Account Management business group ... will report directly to the Healthcare Account Specialist Team Leader.Your impact ... Service Center (PASC) on client..

Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Chicago Illinois Description The Fraud and Waste Professional 2 conducts investigations of allegations of ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..

Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

... Qualifications Minimum 5 years of healthcare fraud investigations and/or auditing experience ... of Florida and Wisconsin Medicaid healthcare payment methodologies Strong organizational, interpersonal, and ... the required qualifications. Understanding..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Chicago Illinois Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..

Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Peoria Illinois Description The Fraud and Waste Professional 2 conducts investigations of allegations of ..

Description The UM Compliance Letters Specialist/Coordinator 2 contributes to administration of utilization management in the Compliance department. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. ..

Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..

Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Clinical Applications Trainer (aka Senior Technology Sales Professional) promotes and sells a portfolio of technical products and/or services and solutions directly to current and new end customers. The Senior ..

Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..

Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..

Job Information Humana Senior Integration Specialist - Cloud in Chicago Illinois Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between development ..