- GCG (Springfield, IL)
- …guidelines and detailed manuals. These efforts will not only support warranty claims but also enhance customer satisfaction by delivering service that sets us ... user-friendly + Develop detailed manuals to assist customers with warranty claims and installation support + Provide on-site training, product demonstrations, and… more
- Datavant (Springfield, IL)
- …positions and perform compensation analysis for different jobs. + Assists with EEOC/DOL claims and any other claims filed against the company, including ... gathering historical employment data and company data. + Assist with OSHA / Safety initiatives for the various offices and manage safety program for all regions assigned. + Works with management on promotions and staff changes to ensure proper documentation is… more
- Highmark Health (Springfield, IL)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician… 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
- Walgreens (Chicago, IL)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Insight Global (Downers Grove, IL)
- …lead a team of adjusters handling complex and high-value worker's compensation claims . This role requires strong technical expertise in managing, thorough knowledge ... 3 Years of Supervisory Experience (5+ Direct Reports) - Experience with Large Loss claims at threshold of $500K or higher - State Jurisdiction Experience within IL,… more
- Walgreens (Chicago, IL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Humana (Springfield, IL)
- …- 3 years of grievance and appeals experience + Previous experience processing medical claims + Bilingual (English and Spanish); with the ability to read, write, and ... English and Spanish + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical terminology + Ability to manage… more
- Amgen (IL)
- …reporting and KPIs tracking; Utilize data sources including IQvia OneKey, Veeva CRM, claims , sales, and internal patient HUB to identify areas of strength and ... or Tableau; 5. Interpreting pharmaceutical data including prescription, physician, and claims level data sets; 6. Analyzing and interpreting market research data… more
- Prime Therapeutics (Springfield, IL)
- …**Responsibilities** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out ... to complex business problems. + Experience with healthcare medical and pharmacy claims data manipulation and analysis. + Master's degree in technical or analytic… more