- AbbVie (Mettawa, IL)
- …patients covered under their numerous healthcare programs have access to our medicines. Medicaid is one of the largest of these programs. AbbVie contributes to the ... and disputes of a large volume of quarterly rebate claims within required timelines. Core Job Responsibilities: + Manage...is responsible for the accurate and timely payment of Medicaid rebates totaling $7 billion annually to state … more
- Walgreens (Chicago, IL)
- …submission of claims to government-sponsored health care programs, including Medicare, Medicaid , and all other third-party payers, as well as the facilitating of ... at the site. Performs all duties of the Pharmacy Manager in their absence **.** **Customer Experience** + Ensures...Resolves third party rejection problems promptly, and resubmits rejected claims for payment on a timely basis. + Manages… more
- Elevance Health (Chicago, IL)
- ** Manager II Grievance/Appeals - Claims Support** This position will work in a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The ** Manager II Grievance/Appeals** is responsible for management oversight of grievances and appeals departmental units to… more
- Elevance Health (Chicago, IL)
- …+ Proficiency within SQL, SAS, Excel, or equivalent. + Proficiency in analyzing Medicaid claims data. + Experience analyzing and building valued based care ... contracts to ensure data accuracy. + Experience working with claims and provider contracts for the Medicaid ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- CVS Health (Chicago, IL)
- …health care more personal, convenient and affordable. **Position Summary** As a Manager , Medical Economics, Medical Expense Review, you will define, develop and ... Medical Economics - Medical Expense Review (MER) across assigned Medicaid Plans. The primary goal of this team is...ensure payment accuracy and recovery projects based on specific claims outlier and trend findings. * Manage a team… more
- Trinity Health (Westchester, IL)
- …with patients, third-party payers, and insurance companies (including Medicare/ Medicaid ) to resolve outstanding balances, investigate claim denials, and ... Case Management, and Managed Care to gather necessary information and ensure claims are processed efficiently. **Key Responsibilities:** + Proactively follow up on… more
- American Institutes for Research (Chicago, IL)
- …full-time **Researcher** with a strong background in Medicare and Medicaid policyto join AIR'sHealth Division (https://www.air.org/our-work/health) . The Researcher ... support to evaluation and analytical support for Centers for Medicare & Medicaid Services (CMS), states, and foundations. Candidates hired for the position may… more
- Fresenius Medical Center (Chicago, IL)
- …providing direction, support and guidance as appropriate. Assists the Insurance Coordinator Manager with the execution of the strategies and initiatives of the IC ... communicating the results and escalates concerns to the IC Manager for review as necessary + Ensures accuracy of...with resolution of identified discrepancies and accounts with outstanding claims to maximize revenue and minimize bad debt. Analyzes… more
- Rush University Medical Center (Chicago, IL)
- …or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service. ... and governmental programs, regulations, and billing processes eg, Medicare, Medicaid , Social Security Disability, Champus, Supplemental Security Income Disability,… more
- Elevance Health (Chicago, IL)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. Pay: the pay for this ... and PC skills. + Processing in FISS and/or MCS claims processing system. + Letter processing/mailing. + Phone calls...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Chicago, IL)
- …VBA models and terms, EMR connectivity, national policies and procedures for claims management and compliance. + Manages admin budget within target. + Oversees ... with contracting for all 3 lines of business (Commercial, Medicaid and Medicare) highly preferred. + Value Based Contracting...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- American Institutes for Research (Chicago, IL)
- …lead tasks related to AIR Health's work with the Centers for Medicare & Medicaid Services (CMS). In addition, the candidate will be expected to participate in ... including associated teams and budgets (in collaboration with a Project Manager or Project Director). + Review and interpret regulatory and sub-regulatory… more
- Rush University Medical Center (Oak Park, IL)
- …or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service. ... and governmental programs, regulations, and billing processes eg, Medicare, Medicaid , Social Security Disability, Champus, Supplemental Security Income Disability,… more