Claims Specialist Jobs in Springfield, IL

Accelerate your career by managing care management support operations, guiding team efforts, and ensuring optimal wellness outcomes for members through effective resource interaction and collaboration...

Champion care management by providing essential support and guidance to members striving for optimal wellness. Collaborate across departments to enhance consumer experiences and ensure effective resou...

Unlock potential by leading a dedicated team to support non-clinical care management processes. Drive member wellness through collaboration, resource connections, and data analysis, while fostering co...

Lead the charge in overseeing medical coding operations, ensuring compliance and quality assurance while supporting the management of MEDCOM contracts. Enhance performance through effective audits, tr...

Support business systems by analyzing user needs, evaluating application suitability, and enhancing operational efficiency through effective solutions and documentation. Collaborate with teams to impl...

Champion operational excellence by leading a dynamic team focused on quality governance, process improvement, and stakeholder engagement, ensuring KPIs are not just met but exceeded through discipline...

Help us redefine pharmacy pricing strategies by leading complex analyses and guiding senior leadership. Partner with cross-functional teams to deliver actionable insights and mentor junior actuaries w...

Lead the charge in optimizing document management standards across collaboration platforms, ensuring organization, adherence to policies, and providing user support to maintain a consistent, accessibl...

Drive Clinical Excellence by reviewing coverage determinations and conducting Medication Therapy Management (MTM) for Medicare Advantage members, ensuring compliance with CMS regulations and enhancing...

Partner with us to oversee critical oncology trials, ensuring compliance, accelerating patient recruitment, and maintaining data integrity while collaborating with a dynamic clinical team. Enhance you...

Drive enterprise-wide reporting solutions by independently designing, developing, and optimizing Microsoft Fabric-Power BI dashboards. Collaborate with teams to translate complex requirements into hig...

Optimize compliance programs across North America, ensuring regulatory adherence in financial services and debt collections, while driving performance improvements and fostering an ethical culture acr...

Optimize execution of Delivery Assurance activities in AMER, ensuring quality standards and engagement success. Collaborate with leaders to analyze performance, enhance partner capabilities, and deliv...

Unlock potential by leading strategic evidence generation and synthesis to inform market access and reimbursement strategies. Oversee cross-functional initiatives and translate complex data into actio...

Innovate in biostatistics by supporting clinical research design and analysis. Collaborate with multidisciplinary teams to provide expert insights, ensuring robust study methodologies and impactful he...

Drive optimal member care by leveraging clinical expertise and collaboration. Analyze utilization trends while advising leadership to ensure compliance with Medicare and state regulations, leading eff...

Innovate product strategies and lead cross-functional teams to deliver impactful solutions across multiple business domains. Drive key initiatives from ideation to launch, ensuring alignment with cust...

Transform product strategy by leading cross-functional teams to drive multi-vertical platform initiatives, ensuring alignment with business goals and enhancing customer experiences for impactful and s...

Transform product vision into strategy by leading cross-functional teams, driving platform success across multiple business lines. Influence stakeholders, deliver impactful solutions, and ensure align...

Transform physical therapy services through expert utilization review, ensuring quality care and adherence to guidelines while collaborating with providers to optimize outcomes and enhance patient rec...

Manage the quoting and pricing strategy to drive competitiveness and profitability. Lead cross-functional teams, ensuring operational excellence and compliance. Develop talent while establishing gover...

Drive clinical optimization strategies across diverse practices, enhancing efficiency and satisfaction. Collaborate cross-functionally to develop actionable insights and reporting tools that support m...

Explore opportunities to enhance market presence in Commercial Roof Coatings by generating leads, managing contractor relationships, and influencing decision-makers. Drive sales growth through strateg...

Optimize customer satisfaction by providing expert support and education in Nuclear Medicine and PET. Act as the primary contact for troubleshooting and training, collaborating with field teams to ens...

Make your mark at a pivotal role managing customer retention and growth, driving upsell strategies, analyzing territory data, and collaborating cross-functionally to enhance the customer experience in...