- Cognizant (Springfield, IL)
- ** Claims Quality Review ** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our ... quality standards, processes and procedures and policies + Ensures the claims processing reps adhere to predetermined quality assurance standards and the… more
- Cognizant (Springfield, IL)
- ** Claims Process Executive ( remote )** **JOB PURPOSE:** Claim Processors will review claim submissions, verify information, adjudicate the claim as per claim ... the business requirements. **ESSENTIAL FUNCTIONS** : + Examining and entering basic claims for appropriateness of care and completeness of information in accordance… more
- Cognizant (Springfield, IL)
- …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review / quality assurance procedures + Must be able ... to transform a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims … more
- WTW (Chicago, IL)
- …You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will contribute to ... and professionally interact with vendor and audit team + Review documentation of potential discrepancies for thoroughness and accuracy...activities in an accurate and timely fashion + Write quality value-added draft report in a timely manner +… more
- Zurich NA (Springfield, IL)
- … Specialist, your primary accountabilities will include: + Work the most complex claims , involving multiple causes of loss, multiple quality issues, subrogation ... policies with the ability to change unit structure pending review outcome + Completes claims on specialty...area + Completes Crop Hail re-inspections when requested for quality assurance purposes + Works claims of… more
- The Hartford (Naperville, IL)
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... help shape the future. This is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy and… more
- Sedgwick (Springfield, IL)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... Financial Services & Insurance Team Leader - Liability | Remote **PRIMARY PURPOSE** : To supervise the operation of...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Prime Therapeutics (Springfield, IL)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with an AI background?… more
- Prime Therapeutics (Springfield, IL)
- …combined pharmacy and PBM experience to include: 1 year of work experience in claims processing in an operations, audit or quality assurance environment, and 1 ... decision we make. **Job Posting Title** Recovery & Resolution Analyst - Remote **Job Description** The Recovery & Resolution Analyst is responsible for recovering… more
- Walgreens (Deerfield, IL)
- …for verifying patient eligibility, coordinating benefits, running test claims , and determining patient coverage/responsibility for services. Handles inbound ... reviews FDA guidelines, and prior authorization requirements to ensure payment of claims . + Resolves questions and problems submitted by customers and Major Medical… more
- CBRE (Springfield, IL)
- Property Management Manager ( Remote ) Job ID 241052 Posted 06-Oct-2025 Service line GWS Segment Role type Full-time Areas of Interest Property Management Location(s) ... Remote - US - Remote - US...Vendor Management: Source, vet, and handle service providers, ensuring quality and cost-effectiveness. + Documentation: Maintain detailed records of… more
- Prime Therapeutics (Springfield, IL)
- …every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst is responsible for ... of reporting requirements through intake and prioritization sessions + Recommend quality and system improvements by analyzing the data issues, maintaining and… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse** to work from our Schaumburg, IL office. ... and resolve issues by working with corporate law, Technical Claims and other, as necessary. + Prepare, attend and...quickly, accurately and in a professional manner. + Meet quality standards by adhering to Best Practices and participating… more
- Walgreens (Deerfield, IL)
- …the data processing system for new patient/new referrals. + Participates in the review /audit of test claims for new patient/new referral. + Handles processing ... needs. **Job Responsibilities:** + Provides pharmacist call back and/or patient quality assurance support. + Responsible for entering patient demographics and… more
- US Foods (Rosemont, IL)
- …business needs & priorities, offering a proven track record of efficiently delivering quality releases on time. They must possess the ability to rapidly earn trust ... **Flexible Work Policy: The work for the Product Owner position is completely remote anywhere in the United States except Hawaii or United States Territories. This… more
- Prime Therapeutics (Springfield, IL)
- …decision we make. **Job Posting Title** Deputy General Counsel, Litigation - REMOTE **Job Description** The Deputy General Counsel Litigation leads the company's ... + Select, manage, and evaluate external legal counsel to ensure high- quality representation + Oversee Prime's Records and Information Management (RIM) program,… more
- Prime Therapeutics (Springfield, IL)
- …every decision we make. **Job Posting Title** Senior Strategy Consultant - Remote **Job Description** The Senior Strategy Consultant is responsible for the ... multiple projects simultaneously **Preferred Qualifications** + Experience with large sets of claims data + In-depth knowledge of PBM industry + Financial analyses… more
- Prime Therapeutics (Springfield, IL)
- …every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst ... stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business partners… more
- Prime Therapeutics (Springfield, IL)
- …decision we make. **Job Posting Title** Forecasting Principal - Finance - Remote **Job Description** The Treasury Analyst Principal is responsible for developing, ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** + Develop, manage, and advance complex… more