- International (Lisle, IL)
- …the newly established Group HR R&D Team, collaborating closely with the HR Manager in the USA, Group R&D Managers, and International counterparts. Together, you will ... HR support and collaborate with the local R&D HR Manager , while serving as a key liaison with the...15,000-person-strong company we are today, few companies can lay claim to a history like International. Based in Lisle,… more
- Elevance Health (Chicago, IL)
- …Analytics Analyst Senior** measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed story to ... and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with SQL, SQL Server,… more
- Elevance Health (Chicago, IL)
- …Jira, Confluence, Bamboo and qTest is a plus. + Health insurance and medical claims knowledge preferred. + Quality certification such as CMQ, CQA, CQPA, CQT, CSQE, ... qTest is a plus. + Health insurance and medical claims knowledge preferred. **For candidates working in person or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- CVS Health (Buffalo Grove, IL)
- …with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... of the reporting. You will report to the Sr. Manager within the Reporting Solutions team. To be successful...AWS/ Azure + Experience working with medical and/or pharmacy claims data + Experience in healthcare industry, including health… more
- ChenMed (Berwyn, IL)
- …filing system updated for multiple procedures/processes. + Assists with pharmacy claims adjudication including calling insurances to assess and correct pharmacy ... claims rejections if appropriate. + Other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of ChenMed… more
- CVS Health (Springfield, IL)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... and the team is highly collaborative. You will report to the Senior Reporting Manager within the Compliance Pharmacy Payments team. To be successful in this role,… more
- Elevance Health (Chicago, IL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Humana (Springfield, IL)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Progress Rail Services Corp. (Lagrange, IL)
- …Significant independent judgment is used, but some direct guidance received from supervisor/ manager ; * Adhere to all Company, Department, and Workgroup policies and ... and/or field service team with summaries of findings as they relate to warranty claims ; * Monitors and audits reports to assure accuracy; * Act as warranty analyst… more
- Ankura (Chicago, IL)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... . Be a key contributor to project delivery teams . Serve as project manager for client services, including large and complex engagements . Support expert witness… more