Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
CVS Health® is seeking a Medical Claims Specialist to review and adjudicate sensitive medical claims. This full-time role in Illinois requires a minimum of 18 months of medical claim processing experience with a health insurance payor. You'll be responsible for ensuring compliance with regulatory requirements, supporting customer service operations, and mentoring team members. The position offers an hourly pay range of $18.50 - $42.35, along with a comprehensive benefits package including medical, dental, and vision coverage. #J-18808-Ljbffr
$18.5 - $42.35 per hour
...We're building a world of health around every individual - shaping a... .... Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established... ...specified claims and those that exceed specialist adjudication authority or...SeniorHourly payFull timeWork experience placementLocal areaRemote work$105k - $120k
...A leading insurance carrier is seeking a Senior General Liability Technical Claims Specialist to manage moderate to complex Commercial General Liability claims. Responsibilities include coverage analysis, negotiation, and settlement of claims, with the ability to work...SeniorRemote work$27.02 per hour
...membership; analyzes data such as individual health, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered... ...across a continuum from routine to highly complex. Engage in teams/workgroups and contribute...SeniorFor contractorsWork at officeLocal area$100k - $125k
...A leading risk and claims administration partner is seeking a Senior Claims Specialist to join their team in Springfield, Illinois. This role requires analyzing and managing complex professional liability claims while ensuring high levels of customer service. With responsibilities...SeniorRemote work$105k - $120k
...Our client, a leading insurance carrier, is seeking to add a Senior General Liability Technical Claims Specialist to their E&S team. This person would be responsible for directly handling moderate to complex Commercial General Liability claims including Slip and Falls,...SeniorRemote work$78.1k - $145.7k
...working environment. A day in the life. As a Senior Claims Consultant, you will be responsible for... ...these skills: Proficient in managing complex construction claims through thorough... ...competitive total rewards package which includes health and welfare benefits, tuition assistance...SeniorMinimum wageWork at officeWork from home$100k - $125k
...Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL | Remote Primary Purpose To analyze complex or technically difficult errors and... ...assistance, flexible spending or health savings account, and other additional voluntary...SeniorWork at officeLocal areaRemote workFlexible hours$122k - $137.25k
...PCI TRGR Penn Pharmaceutical Services Ltd is seeking a Senior Clinical Supply Manager to develop drug supply planning strategies for clinical trials, including complex supply chain management. The ideal candidate will have a Bachelor’s degree and 5–10 years of experience...Senior$46.99k - $122.4k
...CVS Health is seeking a Senior Business Process Engineer to enhance the efficiency of finance processes. This role demands expertise in project... ...intelligence, and process reengineering. Key tasks include analyzing complex workflows and driving improvements. Candidates should have...Senior$50k - $100k
...reimbursement & longevity bonuses Responsibilities Berkshire Hathaway GUARD Insurance Companies is hiring a Workers' Compensation Claims Adjuster in our Complex Unit. The Complex Claims Adjuster handles New Jersey loss time workers’ compensation claims, including litigated files,...SeniorWork at officeRemote workWeekend work- ...Memorial Health System in Springfield, IL is looking for a Billing Analyst to analyze and resolve Medicaid claims, ensuring compliance with guidelines while embodying performance excellence standards. The role requires a high school diploma or GED, with at least two years...
$212k - $318k
...We are seeking a Partner, Senior Health Actuary to join our Actuarial and Financial Group (AFG) in Mercer's Health practice. The location... ...ability to manage client relationships and effectively deliver complex presentations and recommendations. Experience leading and developing...Senior- ...Overview LMI is currently seeking a Senior Wargaming and Table Top Exercise (TTX) Specialist to support wargames, TTXs, and experimentation activities for the... ..., and energy sectors—helping agencies navigate complexity and outpace change. Headquartered in Tysons, Virginia...SeniorRemote work
$77k - $131k
...Medical Coding Automation Senior Associate Join us as we work to create a thriving ecosystem that delivers accessible, high-quality... ...to improve coding quality, reduce denials, optimize claim adjudication outcomes, and strengthen service integrity. The team leverages...Senior$92k - $98k
...Job Title: Senior Manager, SteadyMD Workforce OptimizationLocation: RemoteEmployment Type... ...including Lux Capital, Pelion Ventures and AB Health Ventures.We are currently seeking a... ...forecasting, capacity planning, and scheduling in complex, high-volume environments.Experience in...Senior- ...Senior Clinical Project Manager – Oncology/Hematology (Phase III) (Remote – US/Canada)... ...Senior Project Manager and take ownership of complex Phase III trials, driving projects from... ...the anticipated low and high of the Syneos Health range for this position. Actual salary...SeniorContract workRemote work
$68k - $80k
...Financial Services & Insurance Claims Adjuster - Workers Comp This... ..., filings, and claim adjudication practices. Are you looking for... ...and experience to adjudicate complex customer claims in the context... ...assistance, flexible spending or health savings account, and other...Contract workFlexible hours$115.88k - $261k
...We're building a world of health around every individual - shaping a more connected, convenient... ...with proven ability to distill complex concepts to leaders, colleagues and peers... ...Office technology and software, including Rx Claim and Medispan Demonstrated ability to: manage...SeniorHourly payFull timeTemporary workWork at officeLocal area$128k - $160k
...Guided by our mission to make the world's health data secure, accessible and actionable,... ...'re looking for a strategic and hands-on Senior Product Marketing Manager to lead how Datavant... ...platform to market. You will translate complex, technical offerings across data sourcing...Senior- 6AM City, LLC is seeking a Claims Adjuster to work fully remote from Illinois. In this role, you'll utilize your five years of experience... ...school diploma, and offers a comprehensive benefits package including medical, 401(K), and mental health services. #J-18808-Ljbffr...SeniorRemote work
$190k - $240k
...Guided by our mission to make the world's health data secure, accessible and actionable,... .... About the Role We are seeking a Senior Director of Product to lead the Provider... ...leading teams that design elegant solutions to complex, high-stakes problems. Key...Senior$130k - $160k
...that empower people who improve behavioral health and quality of life of those in need. We... ...technology industry. Summary of the Senior Product Manager, Agentic AI & Healthcare... ...Management experience, with direct ownership of complex workflow platforms. ~ Demonstrated...SeniorLocal areaRemote workFlexible hours$99.3k - $198.7k
...re focused on helping people manage their health more effectively and comfortably, with... ...decisions. The Airtable Product Owner is a senior engineering professional who independently... ...advanced technical expertise to deliver complex work. This role leads the design and development...SeniorWorldwide- ...trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical... ...closely with customers, Data Scientists, and Engineers to translate complex business needs and data science possibilities into clear,...Senior
- A leading healthcare provider in Springfield, Illinois is seeking a skilled Advanced Imaging Cardiologist. This position offers the opportunity to provide cutting-edge care in a supportive, team-based environment. Key responsibilities include utilizing advanced imaging...Senior
- A healthcare provider in Illinois is seeking qualified Physical Therapists to join their dynamic team. In this role, you will provide high-quality care to patients in a skilled nursing facility, evaluate and treat them based on individualized plans, and collaborate with...Senior
$29.78 - $51.22 per hour
6AM City, LLC is seeking a qualified Respiratory Therapist in Illinois, responsible for managing respiratory therapy processes and ventilator management. Candidates must have certifications including ACLS, BLS, RCP, and RRT. The role requires an Associate's Degree in Respiratory...SeniorHourly payRelocation package- A leading healthcare provider in Springfield, IL is seeking a Radiologic Technologist to assist in cardiac and vascular procedures. The role demands a focus on patient care, safety, and maintaining a sterile environment. A relevant associate degree and at least 4 years...Senior
$92.7k - $203.94k
...We're building a world of health around every individual - shaping a more connected, convenient... ...at a time. Position Summary The Senior Software Engineer on the Web Core Previews... ...hands‑on experience building and delivering complex software solutions 5+ years of experience...SeniorHourly payFull timeTemporary workLocal area- Join a dedicated non-profit organization focused on delivering high-quality care in the community. This role offers the opportunity to provide essential physical therapy services while working in a supportive team environment. You'll supervise assistants, collaborate with...Senior
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