Under the supervision of department leadership, this position is responsible for ensuring accurate and timely prior authorization of procedures, medications, and other insurance verifications as assigned. This responsibility includes working to reverse denials, processing appeals and coordinating peer to peer discussions. Secondary focus of this position includes departme

Senior Claims Operations Analyst Requisition ID 2024 25152 Job Locations US IL Lake Zurich Position Type Regular Full Time Category Finance & Accounting Business Unit BUS_TPA US Excellence In Everything We Touch Position Summary Under the general direction of the Claims Data Operations Manager, the Senior Claims Analyst provides a variety of critical operational support s

This position defines and executes the enterprise risk management framework across the organization. Leads activity to balance risk and reward within the enterprise risk appetite. Provides business risk advice, information and results to functions across the organization to provide reasonable assurance regarding the achievement of strategic objectives. Position Compensatio

Who are we? In State Farm Underwriting, we champion profitable growth by providing quality customer interactions and products through simplified processes, technologies, and the excellence of our people. When you join our team, you will execute on your underwriting philosophy and fundamentals to serve the evolving needs of our customers. Check out what it's like to be an

Responsible for providing a wide variety of support services to promote the company's product portfolio via the telephone and internet to support Medicare Solutions Network to increase company revenue and profit. ESSENTIAL DUTIES AND RESPONSIBILITIES Sales Promote the company's product portfolio and provide service assistance to consumers; Respond to consumer inquiries th

A Client Implementation Analyst is responsible for the electronic setup, testing and go live of IT projects that involve Client Claims Processing. These claims may be received either via EDI (Electronic Data Interchange) or via Web Services (near real time technology). The analyst is involved end to end in the process to implement both new business workflows and existing

The Data Entry Clerk is responsible for inputting lists of items, numbers, or other data into the computer; or completing forms that appear on a computer screen. The Data Entry Clerk may also manipulate existing data, edit current information, or proofread new entries to a database for accuracy. Essential Functions and Responsibilities 1. Apply client specifications to ac

To perform this job successfully, an individual must be able to perform each primary duty satisfactorily. Support the team maintaining relationships with approximately 15 clients per person, including key clients Support team members who respond to complex inquiries and resolve problems independently through explanation of facts and details; explain trade processing and c

include, but are not limited to Renew and/or market expiring policies by gathering updated customer information and processing with underwriters/systems for policy issue. Meets customers' daily requests including policy changes, certificates of insurance, provides answers to customer questions. Monitors policy expiration list to be certain that expiring policies are renewe

Superior customer service skills with ability to address and successfully resolve complex and sensitive field issues Expert technical knowledge Excellent communication skills, both written and verbal NRF Benefits Great pay package, 401K, company sponsored retirement plan, educational assistance, performance based incentive pay, medical, dental and vision insurance, parent

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary This position is responsible for de

Utilization Management Specialist Carbondale, IL Post Date Mar 20, 2024 Location Carbondale, IL, US, 62901 Position Type Full Time Requisition Number 31696 Work Schedule Monday Friday Are you looking to find personal and professional fulfillment, and align your career with your values? At Gateway Foundation, our employees have an opportunity to make a difference every day

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under Supervision, This Position Is

include but are not limited to Follow up and collection of all inpatient and outpatient accounts from admission to discharge and final resolution of accounts. Other duties will include billing and cash posting responsibilities. KNOWLEDGE, SKILLS, AND ABILITY Knowledge of coding Knowledge of basic business office/average to high math skills. Knowledge of third party procedu

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under Supervision, This Position Is