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.
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.
NewSupervisor - Pharmacy Adjudication Onco360Supervisor - Pharmacy AdjudicationWoodridge, IllinoisSkills/Knowledge Required: NDC medication billing, PBM and medical contracts, healthcare audit experience, knowledge of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, excellent interpersonal skills, able to work with all levels of management and staff, vast knowledge of pharmacy terminology and process including sig codes, and roman numerals, brand/generic names of medication, advanced typing, math and analytical skills. Assists Director of Pharmacy Operations in day-to-day pharmacy operations and in implementing new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all patients using effective service leadership and customer skills.
Respiratory Therapist US Department of Health and Human ServicesRespiratory TherapistIL$52,783–$75,989 / yearMINIMUM QUALIFICATIONS: GS-08: 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: Performing a variety of difficult respiratory therapy such as administering various medications to patients with acute and chronic respiratory distress. Specialized Experience for positions at GS-4 and above: Qualifying specialized experience must have demonstrated a knowledge of basic equipment used in respiratory therapy and included duties such as: Making regular rounds on hospital nursing units to review or collect clinical data to insure that the respiratory equipment is operating properly and in compliance with physicians orders.
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.
NewCommercial Underwriter Bank of MontrealCommercial UnderwriterIL$55,000–$120,000 / yearBuilds change management plans of varying scope and type; leads or participates in a variety of change management activities including readiness assessments, planning, stakeholder management, execution, evaluation and sustainment of initiatives. Keeps current with established processes, policies, and regulations, and knowledge of products, credit policies, services, and relevant legal, regulatory, and technology requirements.
Medical Support Assistant (PRC) US Department of Health and Human ServicesMedical Support Assistant (PRC)North Chicago, IL$40,736–$52,957 / yearExamples include screening and interviewing patients or customers to obtain or verify information; inputting and updating data in computerized data system; performing a variety of customer service duties such answering telephones, responding to inquiries, preparing correspondence, and maintaining files; and explaining policies and procedures to patients or customers. Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf .
Diagnostic Radiologic Technologist (CT) US Department of Health and Human ServicesDiagnostic Radiologic Technologist (CT)IL$64,924–$93,227 / yearCareer Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf . The following meet these requirements: Individuals employed by the Federal Government as radiologic personnel before January 13, 1986, may qualify based on evidence of current or satisfactory performance, or certification from a licensed practitioner authorized to prescribe radiologic procedures (such as a physician, osteopath, dentist, podiatrist, or chiropractor).
Junior Compliance Officer (Operations, Junior Analyst) The MIL CorporationJunior Compliance Officer (Operations, Junior Analyst)Chicago, IL$35,000–$48,000 / yearAssociates degree in Business, Accounting, Finance, Information Systems, Criminal Justice, or a related field is required; Bachelors degree in Business, Accounting, Finance, Information Systems, Criminal Justice, or a related discipline is preferred. The role assists in reviewing employment eligibility documentation, conducting database research, and preparing audit-ready case files and reports that support administrative enforcement actions and related determinations.
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.
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.