- CVS Health (Springfield, IL)
- …analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs. + Completes financial forecasting and ... analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers and identifies… more
- Centene Corporation (Springfield, IL)
- …related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, claims , contracting ... + Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform… more
- Highmark Health (Springfield, IL)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary ... school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician… more
- Guidehouse (Chicago, IL)
- …reflects our commitment to creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and Family Sick ... Power BI, Tableau, TIBCO Spotfire or others + Strong understanding of healthcare claims (facility or payer) data and/or HIT applications including those used to… more
- Aston Carter (Vernon Hills, IL)
- …critical administrative support to the sales team, track shipments, manage claims , and handle customer communications, ensuring a seamless order processing ... UPS or other carriers; initiate and manage investigations and claims . + Communicate shipping dates, potential delays, and other...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- BrightSpring Health Services (Danville, IL)
- …Community Living + Great Company Culture + Competitive Pay + Employee Benefits; including Medical , Dental and Vision insurance + 401K + Daily Pay Option ... personnel costs, consultant services + Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to reduce… more
- Evolent (Springfield, IL)
- …and member-centric products. This role plays a critical part in both ** Medical Cost Management** and **Product Management** , leveraging advanced analytics to solve ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- Fujifilm (Springfield, IL)
- …and communication skills. **Salary and Benefits** + $145,000 - $165,000 depending on experience + Medical , Dental, Vision + Life Insurance + 401k + Paid Time Off ... Code of Conduct, Interactions with Healthcare Professionals Policy, Anti-Kickback, False Claims Act, HIPAA, Anti-Corruption Policy and Antitrust Policy among others,… 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...a comprehensive benefits package. Benefits can include Group Health ( Medical , Dental, and Vision), Paid Time Off, Paid Holidays,… more
- UIC Government Services and the Bowhead Family of Companies (Springfield, IL)
- …of Defense and many federal agencies. Bowhead offers competitive benefits including medical , dental, vision, life insurance , accidental death and dismemberment, ... 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… more
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