- 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
- The Robison Group (Springfield, IL)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... results (except when undergoing documented medical treatment). + College Degree preferred . TRAINING The Robison Group provides remote training to ensure that… more
- Rush University Medical Center (Chicago, IL)
- …analytical skills. High degree of accuracy for analyses and processes. ** Preferred Job Qualifications:** * General understanding of various billing, payment and ... CMS and AMA guidelines 2. Responsible for assigned Account, Charge Review, and Claim Edit Work queues and the continual monitoring, reduction, and transfer of AR… more
- Siemens (Buffalo Grove, IL)
- …continuous improvement across our supplier base. Reporting to the Supplier Quality Manager , you will work closely with Procurement, Engineering, and suppliers to ... for improvement. Develop and maintain supplier quality metrics such as PPM, claim rates, NCCs, etc. to monitor supplier performance and drive accountability.… more
- Jack Henry & Associates (Lombard, IL)
- …Full-Time Position Type Regular Travel Requirements 0% Workplace Type Onsite Preferred Location Lombard, IL Additional Locations Lombard, IL Description & ... The final salary will be set by the hiring manager . What you'll be responsible for: + Performing electronic...complaints of discrimination of any kind, pursuing any discrimination claim , or cooperating in related investigations. Requests for full… more
- Pearle Vision (Schaumburg, IL)
- …management. JOB TITLE: Optometric Office Technician REPORTS TO: Store General Manager FLSA STATUS: Hourly; Non-Exempt POSITION PURPOSE: The major responsibility of ... Adjust scheduling for priority patients * Scheduling appointments * Processing insurance claim forms * Patient and insurance billing * Optometric medical billing and… more
- Deloitte (Chicago, IL)
- …as general health and group benefits skills. Key Responsibilities + Lead project manager for specific projects or key workstream lead on larger projects. + Evaluate ... Pharmacy Benefit Manager (PBM) contracts, deal terms, and financial proposals. +...reviewing services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against… more
- Zurich NA (Schaumburg, IL)
- …a subject matter expert for IBM FileNet P8, including IBM Content Navigator Case Manager and Process Engine + Work with IT Leadership and stakeholders in the ... liaison between the Business and IT, as assigned. + Support the Portfolio Manager in building the Business Case, including cost / benefit analysis, risk assessment,… more
- Evolent (Springfield, IL)
- …experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical data) is preferred + Prior ... value, in keeping with the MVP model + Works with the Product Manager to translate the roadmap features into well-defined development criteria including features,… more
- Jabil (Gurnee, IL)
- …and gathers knowledge and experience to qualify for future Business Unit Manager opportunities within 2-3 years, depending upon business need.. Manages a piece ... Prepares materials for Request for Proposal (RFP) responses.. Prepares commercial claims (eg excess and obsolete materials).. Contributes to the forecast &… more