- Ankura (Chicago, IL)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... trade association guidance; and international compliance standards governing pharmaceutical and medical device operations. You will be joining a team of industry… more
- R1 RCM (Chicago, IL)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... Denials Consultant, you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages of the… more
- ProSmile (Oak Park, IL)
- …Responsibilities The duties include, but are not limited to: + Audit charts + Submit claims + Enter insurance payments + Follow up on outstanding claims and ... week) and Part Time Benefits Eligible Positions (30-35 hours per week): + Medical Insurance: Choice of five comprehensive Aetna medical plans, including options… more
- Evolent (Springfield, IL)
- …patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical economics activity, and a ... team in the analysis and interpretation of cost and utilization data ( medical and pharmaceutical) to explain potential upside/downside risks of a given… more
- Pfizer (Lake Forest, IL)
- …forecasting, predictive modeling. + Consulting experience and experiences of analyzing patient/ claims data is highly desired. + Deep understanding of pharmaceutical ... product reimbursement process for both medical and pharmacy products. + Demonstrated ability in managing...sets. + Expertise of using common pharmaceutical and payer claims datasets (IQVIA LAAD) and copay/affordability data sources (CoverMyMeds,… more
- AbbVie (Mettawa, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... payer formulary access that maximize net sales for assigned brands. Identify through claims analysis, market dynamics that shape brand demand and build models to… more
- Walmart (Quincy, IL)
- …to ensure proper diagnosis and treatment by reviewing complete patient medical history information and performing comprehensive eye examinations; examining eyes ... using evidence-based care guidelines and patient preferences; referring patients with medical conditions outside of vision care services to appropriate community… more
- Walgreens (Mount Prospect, 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
- CVS Health (Springfield, IL)
- …well as for internal staff that aligns PE/Network functions with Operations and Claims as needed + Research, review, and prepare responses for all governmental, ... interpretation * Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and/or Network Performance Standards… more
- Walgreens (Springfield, 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