- Walgreens (Loves Park, IL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... the Pharmacy Manager. + Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of… more
- Humana (Springfield, IL)
- …clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key ... or managed care working experience + Experience working with medical, pharmacy, lab claims + Experience working with big data and using PySpark, Spark R or… more
- Sedgwick (Moline, IL)
- …not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- CVS Health (Springfield, IL)
- …complaints and appeals received by the organization. This includes denied claims , coverage issues, medical necessity, service quality, or other concerns expressed ... Excel, PowerPoint, Outlook). **Preferred Qualifications** + Prior experience working with claims . + Prior experience in health insurance. + Prior experience in… more
- Humana (Springfield, IL)
- …cause analysis of audit findings and submits recommendations for appropriate change management . + Applies clinical and coding experience to conduct reviews of ... complete and accurate. + Certified Professional Coder or coding knowledge. + Claims knowledge and understanding of claims processing. **Additional Information**… more
- Walgreens (Evanston, IL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... the Pharmacy Manager. + Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of… more
- Robert Half Office Team (Manteno, IL)
- …standards. * Provide comprehensive support for leave of absence cases, disability claims , and workers' compensation, acting as a liaison between employees and ... and implement company policies, offering guidance on employee relations and performance management to mitigate risks. * Maintain and track employee training records,… more
- Zurich NA (Chicago, IL)
- …and coordinating with the appropriate business partner for resolution (ie claims adjusters, underwriters). + For new and existing customers, assist underwriting ... regulatory requirements, reporting, risk engineering coordination, premium payment processes, claims flow issues, and money/currency movement. + Handle specific… more
- Stryker (Chicago, IL)
- …Engage in all aspects of intellectual property disputes, including pre-litigation claims , lawsuits, and contested administrative proceedings. + Evaluate and respond ... to pre-litigation claims relating to intellectual property, including licensing offers. + Assist with day-to-day management of intellectual property lawsuits,… more
- Evolent (Springfield, IL)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more