- Humana (Springfield, IL)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
- Humana (Springfield, IL)
- …The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments ... make an impact** **Required Qualifications** + 5+ years of claims operations related experience + Experience with analyzing, reconciling...SQL & Access) + Prior experience in a fast-paced insurance or health care setting + Experience with creating… 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
- Zurich NA (Schaumburg, IL)
- …experience in the Reinsurance, Insurance or Finance areaOR + Zurich Certified Insurance Apprentice, including Associate Degree and 4 or more years of ... and department standards + Handling and collection of reinsurance claims of moderate to high complexity + Reconcile complex...experience in the Reinsurance, Insurance or Finance areaOR + High School Diploma or… 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
- Evolent (Springfield, IL)
- …require technical experts to find the most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs may be engaged in any testing ... - Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in… more
- Robert Half Accountemps (Naperville, IL)
- Description We are looking for an Account Specialist, Associate to join our team in Houston, Texas. This long-term contract position offers an opportunity to provide ... teams to develop effective solutions to complex customer issues. * Process claims , contractor invoices, and enrollment requests with accuracy and efficiency. *… more
- Zurich NA (Chicago, IL)
- …their risk and offering the best end to end solution for their insurance needs. + Using a disciplined approach to exposure evaluation, risk assessment and ... division + Administering and monitoring underwriting rules and guidelines, insurance laws and regulations and rating manual rules +...and 2 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of the… more
- Zurich NA (Schaumburg, IL)
- …more years of experience in the Administrative Support areaOR + Zurich Certified Insurance Apprentice including an Associate Degree and No prior experience ... needs in mind, the ZNA hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating… more
- Zurich NA (Schaumburg, IL)
- …experience in software product management or product development areaOR + Zurich Certified Insurance Apprentice, including Associate Degree and 7 or more years' ... experience utilizing JIRA or similar tooling + P&C - Commercial Insurance , Claims , or Underwriting system experience desired + Strong verbal and written… more