- Evolent (Springfield, IL)
- …+ Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns, ... Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and various… 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
- Fujifilm (Springfield, IL)
- …Code of Conduct, Interactions with Healthcare Professionals Policy, Anti-Kickback, False Claims Act, HIPAA, Anti-Corruption Policy and Antitrust Policy among others, ... + Strong understanding of healthcare regulations (eg, Anti-Kickback Statute, False Claims Act) and global compliance frameworks (eg, FCPA, UK Bribery Act).… more
- Elevance Health (Chicago, IL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
- HTC Global Services Inc (Chicago, IL)
- …analyzing and improving the Quality of the vehicles built. + Review incoming warranty claims data on a daily basis, review customer and dealership comments, bin ... claims into proper binning categories, contact dealership/s for parts...Off, Paid Holidays, 401(k) matching, Group Life and Disability insurance , Professional Development opportunities, Wellness programs, and a variety… more
- UIC Government Services and the Bowhead Family of Companies (Springfield, IL)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- UNUM (Springfield, IL)
- …Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
- Leviton (Northbrook, IL)
- …Marketing Materials, and delivery status. Provide support for Customer Claims including deductions, pricing discrepancies, and return orders. Qualifications ... We Offer Comprehensive benefits include: Medical, dental, and vision insurance programs 401K plans with employer-matching contributions Tuition reimbursement PTO… 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
- UIC Government Services and the Bowhead Family of Companies (Springfield, IL)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more