Top Tech Jobs & Startup Jobs in Chicago, IL

The Senior Analyst, SIU Coding Auditor investigates medical claims for fraud, manages caseloads, and ensures compliance with regulations.

The Senior Analyst, Payment Integrity will improve processes and resolve claim issues, leveraging health insurance knowledge and stakeholder collaboration.

The Senior Specialist audits medical records and claims to assess FWA trends in healthcare, communicating findings, and training team members.

Perform line-by-line reviews of high-dollar facility itemized bills and claims (UB-04), identify billing/coding errors, validate codes (CPT, HCPCS, ICD-10, MS-DRG), compare charges to contracts and policies, document findings and recommended adjustments, refine audit processes, provide SME guidance and training, and collaborate cross-functionally to remediate payment integrity issues.

The Sales Executive is responsible for driving sales by identifying leads, qualifying prospects, setting meetings, and collaborating with marketing while ensuring compliance and improving processes.

The WFM Specialist will optimize scheduling and staffing to meet business requirements, monitor service levels, and communicate adjustments to stakeholders.

Support end-to-end member data and payer eligibility to ensure accurate claims processing. Conduct payer/provider outreach for overpaid claims, make outbound provider calls, document recovery activities, escalate disputes, and assist leadership with scoping and prioritization.

Manage and negotiate national ancillary provider contracts, support network growth and recruitment, analyze provider performance and financials, resolve provider issues, implement contracting strategy and workflows, mentor junior staff, and ensure regulatory compliance while meeting SLAs and travel requirements.

Manage and negotiate contracts with hospitals and large ancillary providers to build a high-performing network. Analyze provider performance and financial data, support national network strategy, ensure regulatory compliance, collaborate with provider services, and meet SLAs and cost-saving objectives.

Perform end-to-end claims coding audits and repayment quality reviews using CPT/HCPCS/ICD-10 guidelines; document findings, create reference guides, support provider communications, train teammates, and drive process improvements for payment integrity.