- Evolent (Springfield, IL)
- …accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based care, and the levers to optimize financial ... be leveraged to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data and insights… 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
- AbbVie (Mettawa, IL)
- …institutional sales data, payer-prescriber-level data, formulary data, Rebates, Symphony claims , Copay claims . + Excellent communication and interpersonal ... package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees. + This job is eligible to… more
- Hy-Vee Food Stores (Quincy, IL)
- …performance reviews, scheduling, benefits, wages, etc. and acts as the Insurance Coordinator and 401(k) Coordinator. + Handles and satisfies customer complaints, ... employee wage and employment verifications, as well as disability claims , leave of absence requests, and extensions. + Records...extensions. + Records and follows up on Workers Compensation claims and issues and fills out accident reports on… more
- Elevance Health (Chicago, IL)
- …Analytics Analyst Senior** measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed story to ... and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with SQL, SQL Server,… more
- ChenMed (Berwyn, IL)
- …taking inventory, answering the phone, checking patient information for insurance co-pays, restocking and ordering necessary supplies, assisting with delivery ... filing system updated for multiple procedures/processes. + Assists with pharmacy claims adjudication including calling insurances to assess and correct pharmacy … more
- ChenMed (Chicago, IL)
- …receipt; removing outdated drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains a safe and ... as assigned by the Pharmacy Manager or Pharmacist on duty. + Processes claims for 3rd party reimbursement efficiently and correctly to third-party insurance … more
- Centene Corporation (Springfield, IL)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- Walgreens (Deerfield, 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
- Walgreens (Deerfield, 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