Claims Adjudicator II UNITE HERE HEALTHClaims Adjudicator IIOak Brook, ILRemote$20.36–$24.97 / hourActual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered.
NewProduct Manager – Tech Delivery - Application Security Adjudication & Risk Management Bank of AmericaProduct Manager – Tech Delivery - Application Security Adjudication & Risk ManagementChicago, WashingtonThe Product Manager – Tech Delivery will be a member of the Business Information Security Officer's (BISO) organization and work closely with Line of Business (LOB) Chief Information Officers (CIOs), Chief Technology Officers (CTOs), application development teams, architects, and technology partners. The successful candidate will partner closely with development teams, architects, security engineers, product owners, and risk partners to drive secure development practices, vulnerability remediation, and risk-based security decision making across the enterprise.
Part Time Adjudication Specialist City of Elgin, ILPart Time Adjudication SpecialistElgin, ILPerform the job functions of the full-time Adjudication Specialist and City Hall Security Officer in the absence of the employees assigned to those functions or when requested; refer to job description for those positions. Position is cross trained in the Court Liaison Officer and City Hall Security Officer job functions and is expected to cover those positions as needed.
NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWoodridge, IllinoisSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Consultant, Payment Intelligence Aarete LLCConsultant, Payment IntelligenceChicago, IL$84,000–$102,000 / yearAArete, LLC ("AArete") may utilize Artificial Intelligence/Automated Decision-Making Technology/Automated Employment Decision Technology tools and resources ("AI" or "tools" or "resources") to assist humans in generating job descriptions and postings, recruitment, analyzation of information, screening candidates, evaluation of candidate information, and assisting humans in the selection of potential candidates by all levels of AArete employees for all positions. We've earned a Great Place to Work Certification and been named a World's Best Management Consulting Firm by Forbes, Vault's Top 50 Firms to Work For, Crain's Chicago Business Fast 50, Inc 5000's Fastest Growing Firms, and Consulting Magazine's Fastest Growing Firms.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)IL$37,193–$65,599 / yearMINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of general and/or specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: GS-04: One (1) year of general experience is progressively responsible clerical, office or other work that indicates ability to acquire the particular knowledge and skills needed to perform the duties of this position. Examples include: Enter transaction codes and data for third party billing; Work with automated records systems, data entry and encoder software; collaborate with customers and counter parts to clarify or obtain pertinent medical record information; Use coding conventions, techniques, coding rules and regulations; use of multi automated systems to obtain and code medical record data.
NewTax Law Specialist Department of the Treasury, USTax Law SpecialistChicago, IL$147,945–$197,200 / yearCoordinates, on behalf of the Division Commissioner or Division Director/Director, Technical Guidance, or Director ACA with the Office of the Chief Counsel, Health Care Counsel, other Operation Divisions and/or Justice Department in providing technical advice and assistance in connection with ACA, employee plans, exempt organizations, or government entity or appeals matters in litigation or preparing to go to litigation. You must also meet the following requirement(s): TIME AFTER COMPETITIVE APPOINTMENT (TACA): Current civilian employees must have completed at least 90 days of federal civilian service since their latest non-temporary appointment from a competitive referral certificate, known as time after competitive appointment.
Medical Technician (Laboratory Support) US Department of Health and Human ServicesMedical Technician (Laboratory Support)IL$37,193–$65,599 / yearGS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Performing CLIA-waived laboratory testing and documenting quality control activities; Collecting routine venipuncture and capillary specimens while verifying patient identity and documentation; Preparing, labeling, storing, and accessioning specimens into laboratory information systems; Maintaining laboratory supplies, equipment, and logs in compliance with biosafety and infection control procedures; Providing laboratory support by distributing reports, instructing patients on specimen collection, and assisting with routine cleaning and sanitizing of laboratory areas. Six (6) months of specialized experience performing technical medical laboratory support work such as performing laboratory tests and examinations (chemical, microbiologic, hematologic and blood banking) and preparing reports of findings or technical support work in a closely related, field such as biological laboratory technician work, that required application of the methods and techniques for the position to be filled.
Nurse (QAPI) US Department of Health and Human ServicesNurse (QAPI)IL$98,244–$127,725 / yearMINIMUM QUALIFICATIONS: GS-11: Applicants must successful complete a PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field -OR- possession of a diploma, associate degree, bachelors degree, or masters degree from a professional nursing educational program AND Your resume must demonstrate at least one full year of professional nursing experience (equivalent to the GS-9 grade level) in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Facilitating the collection, monitoring and reporting of data; coordinate the identification and evaluation of important/potential problems or related concerns relating to the care or patients; investigate, plan and implement corrective action for problems; assisting department heads to investigate problems, determining action and prepare problem analysis reports. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only."
Occupational Therapist US Department of Health and Human ServicesOccupational TherapistIL$74,678–$116,362 / yearGS-12: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Demonstrate occupational therapy screening, evaluation, and reevaluation processed providing verbal or written reports of observations and patient capabilities, examination and treatment of patients, using appropriate tools/tests to asses patient dysfunction and develop, implement, and communicate the occupational therapy intervention plan based on the evaluation, patient goals; current best evidence and clinical reasoning. Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Program planning, monitoring, and adhering to established Occupational Therapy Performance, Provide Occupational Therapy consultation, evaluation and treatment for inpatient and outpatient clinics.
Social Worker US Department of Health and Human ServicesSocial WorkerIL$65,381–$104,502 / yearMINIMUM QUALIFICATIONS: GS-11: One (1) year of specialized experience equivalent to the GS-09 level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Conducting comprehensive biopsychosocial and mental health assessments; Coordinating services to support patient stability and continuity of care; Responding to urgent psychosocial situations by conducting timely risk and safety assessments, and; Consulting with medical, nursing, and behavioral health providers regarding patient needs, barriers and service coordination. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only."
Medical Support Assistant (Patient Registration) US Department of Health and Human ServicesMedical Support Assistant (Patient Registration)IL$40,736–$66,857 / yearMINIMUM QUALIFICATIONS: GS-05: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Provides front office and administrative support for a healthcare clinic by greeting and assisting patients, scheduling appointments, maintaining medical records, and completing clerical tasks. of: a.) 3.0 or higher out of a possible 4.0 (B" or better) as recorded on their official transcript, or as computed based on 4 years of education, or as computed based on courses completed during the final 2 years of the curriculum; or b.) 3.5 or higher out of a possible 4.0 ("B+" or better) based on the average of the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum.
Lead Medical Records Technician (File Room) US Department of Health and Human ServicesLead Medical Records Technician (File Room)IL$52,783–$68,620 / yearGS-07: MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Leading, training, and mentoring employees in a healthcare environment; Assisting patients, health care providers, insurance companies, attorneys and other health care facilities by providing current and historical medical records and other pertinent patient data as requested. Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.