- 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
- 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
- Lincoln Financial (Springfield, IL)
- …will contribute to strategic projects requiring group protection and claims business/technology knowledge, project & stakeholder management, and presentation skills. ... supporting change management and/or departmental/enterprise initiatives within group protection claims . * Provides direction on organizational readiness planning and… 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
- Humana (Springfield, IL)
- …**Required Qualifications** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, ... Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience in a… more
- Humana (Springfield, IL)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,...off, paid parental and caregiver leave), short-term and long-term disability , life insurance and many other opportunities. Application Deadline:… more
- JBT Corporation (Chicago, IL)
- …advising on compliance requirements, employment agreements, employee administration, HR policies, claims and dispute resolution. Collaborate with the HR team to ... your employment. Including: Medical, Dental, life insurance, short-term and long-term disability , family leave, vision coverage, and a matched 401(k) plan.… more
- Turner & Townsend (Chicago, IL)
- …advanced techniques including Time Impact Analysis (TIA), productivity tracking, and claims support. Collaborate with regional leads to elevate service quality and ... desirable + Additional certifications in construction scheduling, delay analysis, or claims management beneficial + OSHA 30 or equivalent safety training recommended… 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 ... to race, color, sex, sexual orientation, gender identity, religion, national origin, disability , veteran status, or other legally protected status. At Datavant our… more