- 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
- Sedgwick (Moline, IL)
- …at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job ... postings. Actual compensation is influenced by a wide range of factors...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Evolent (Springfield, IL)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Progress Rail Services Corp. (Lagrange, IL)
- …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 ... * Perform Special assignments as required; * Approve/administer warranty claims problems/disputes as needed; * Investigate/ resolve warranty request… 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
- Sedgwick (Springfield, IL)
- …at any time. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job ... postings. Actual compensation is influenced by a wide range of factors...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Humana (Springfield, IL)
- …MAAA + 2+ years of actuarial experience in health insurance and/or medical claims analytics + Proficiency in data analysis and one or more statistical programming ... Strong communication skills + Strong working knowledge of healthcare claims as it relates to trend analytics, total cost...be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of… more
- Sedgwick (Springfield, IL)
- …and talking As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in ... job postings. Actual compensation is influenced by a wide range of factors...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Guidehouse (Chicago, IL)
- …client business problems, which include but are not limited to medical and pharmacy claims (open and closed), formulary and managed care data, and EMR data. + ... Ability to work with large data sets such as claims data. + Excellent attention to detail and ability...The annual salary range for this position is $118,000.00-$196,000.00. Compensation decisions depend on a wide range of factors,… more
- Evolent (Springfield, IL)
- …public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care, or related ... healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and various sites of… more