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Reimbursement Case Manager Jobs in Springfield, IL

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Reimbursement Case Manager information

See Springfield, IL salary details

$14

$24

$42

How much do reimbursement case manager jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for reimbursement case manager in Springfield, IL is $24.54, according to ZipRecruiter salary data. Most workers in this role earn between $19.04 and $26.68 per hour, depending on experience, location, and employer.

What is the difference between Reimbursement Case Manager vs Claims Specialist?

AspectReimbursement Case ManagerClaims Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare facilities, insurance companies, or managed care organizationsInsurance companies, third-party administrators, or healthcare providers
Job FocusManaging reimbursement processes, verifying coverage, and resolving billing issuesProcessing claims, reviewing documentation, and ensuring accurate claim submission

Reimbursement Case Managers and Claims Specialists both work within the healthcare and insurance industries, focusing on financial aspects of patient care. While Reimbursement Case Managers primarily handle reimbursement processes and coverage verification, Claims Specialists concentrate on processing and reviewing insurance claims. Both roles require knowledge of insurance policies and healthcare billing, but their daily tasks and focus areas differ slightly.

How does a reimbursement case manager typically collaborate with healthcare providers and insurance companies to resolve patient billing issues?

Reimbursement Case Managers act as key liaisons between healthcare providers, patients, and insurance companies to ensure that claims are processed accurately and efficiently. They regularly communicate with medical staff to collect necessary documentation, clarify coding, and verify treatment details. Additionally, they work closely with insurance representatives to address denials, appeal decisions, and troubleshoot payment delays. This collaborative approach requires strong communication skills and a deep understanding of both clinical and insurance processes.

What are the key skills and qualifications needed to thrive as a reimbursement case manager?

To thrive as a Reimbursement Case Manager, you need a solid understanding of healthcare reimbursement processes, insurance policies, and medical billing, often supported by a background in nursing, social work, or healthcare administration. Familiarity with claims management systems, electronic health records (EHRs), and payer portals is typically required, and certifications like CCM (Certified Case Manager) can be advantageous. Strong communication, problem-solving, and organizational skills help you effectively advocate for patients and collaborate with providers and payers. These competencies ensure accurate reimbursement, compliance, and optimal patient outcomes in a complex healthcare environment.
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Reimbursement Case Manager jobs near you

RN Case Manager in Springfield, IL

Vivian Health

Springfield, IL • On-site

$66K - $142K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 23 days ago

Job description

Case Manager, Registered Nurse - Field (Iroquois/Kankakee, IL)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Program Overview:

*Candidates must live in or near Kankakee, Iroquois or surrounding counties, IL*

Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

Position Summary
The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources

Remote Work Expectations

  • This is a remote/field role; candidates must have a dedicated workspace free of interruptions

  • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.


Required Qualifications

• Must reside in the state of Illinois

•Must possess reliable transportation and be willing and able to travel up to 75% of the time from home location in and around Kankakee, Iroquois, Livingston, Ford, Champaign and surrounding counties, IL. Mileage is reimbursed per our company expense reimbursement policy
• Minimum 3-5 years clinical practical experience
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

Preferred Qualifications

• 2-3 years Care Management, discharge planning and/or home health care coordination experience

• Certified Case Manager
•Bilingual


Education

Associate's degree required, along with active and unencumbered Registered Nurse license in the state of Illinois

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,575.00 - $142,576.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/28/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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