- Cognizant (Springfield, IL)
- …for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a ... and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and… more
- NTT DATA North America (Decatur, IL)
- …as assigned. **REQUIREMENTS:** + High School Education. + Minimum 3 years' experience in Healthcare Claims Processing role + Minimum 1 year experience in ... an overall sourcing strategy. NTT DATA currently seeks a Claims Auditor to join our team for a remote...of Direct Hire Pay Rate $21-$22/hr **Position Summary:** The Claims Auditor position reports to the Chief Administrative Officer.… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …for you! The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and first-pass resolution rates. + ... at least 6 years relevant IT experience overall. + Experience in the Healthcare industry domain, including and especially Claims systems experience. + Experience… more
- Evolent (Springfield, IL)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Evolent (Springfield, IL)
- …analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- HUB International (Chicago, IL)
- …a plus. Experience: A minimum of 3-5 years of experience in the PBM industry, healthcare claims auditing, or a related field. Direct experience with PBM audits ... of Pharmacy Benefit Managers (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data… more
- Cognizant (Springfield, IL)
- …claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...* Good skills at problem resolution specifically related to healthcare claim adjudication. * Possess ability to work at… more
- CVS Health (Springfield, IL)
- …. 3+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance carrier, third party ... . 5+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance carrier, third party … more
- Evolent (Springfield, IL)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care,… more
- Evolent (Springfield, IL)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... to our culture. **What You'll Be Doing:** + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to… more