- Elevance Health (Chicago, IL)
- ** Medical Claims Data Integrity Consultant** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Chicago, IL; Louisville, KY (preferred). This role ... position is not eligible for current or future visa sponsorship._ The ** Medical Claims Data Integrity Consultant** (Business Information Developer… more
- NTT DATA North America (Decatur, IL)
- …future for NTT DATA Services and for the people who work here. NTT DATA seeks a ** Claims Examiner** on a **project** basis to work **remote, from home** ... right people on board, anything is possible. The quality, integrity , and commitment of our employees are key factors...Experience in the GBAS system + Experience processing Dental Claims \#LI-NorthAmerica **About NTT DATA ** NTT … more
- Axis (Chicago, IL)
- …taking part in the selection process. About the Team AXIS is hiring a Senior Claims Specialist - EPL and Fiduciary Claims for its North America Claim Team. ... This role involves managing primary and excess claims for various AXIS policy forms. How does this... adjusters. Supporting underwriting and actuarial teams by maintaining data and analytics. Maintaining and developing relationships with senior… more
- NTT DATA North America (Decatur, IL)
- …future for NTT DATA Services and for the people who work here. NTT DATA seeks a ** Claims Refund Specialist** on a **project** basis to work **remote, from ... At NTT DATA , we know that with the right people on board, anything is possible. The quality, integrity , and commitment of our employees are key factors in our… more
- Elevance Health (Chicago, IL)
- …fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Humana (Springfield, IL)
- …and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data . Maintain dashboards to communicate key ... trends to stakeholders. The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …Commercial third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data , Specialty pharma, omnichannel data , SalesForce/Veeva ... **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for… more
- AbbVie (Mettawa, IL)
- …MBA + Strong working knowledge of syndicated pharmaceutical data sources, including formulary data sources and claims data sources. + 3-4 years of ... 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… more
- AbbVie (Mettawa, IL)
- …program including data governance, syndicated data operations, promotional data operations, patient claims data operations, commercial MDM, and ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...to join our organization as the Director II, APEX Data Transformation, reporting directly to Senior Director, APEX Enterprise.… more
- USAA (Chicago, IL)
- …families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity , loyalty and service - define how we treat each other and our members. ... responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate… more
- Elevance Health (Chicago, IL)
- … medical guidance across multiple enterprise transformation initiatives, including: + ** Medical Cost Management** + **HealthOS and enterprise data platforms** ... payer, managed care, or healthcare leadership preferred. + Experience advising medical cost management, utilization management, payment integrity , or provider… more
- Rush University Medical Center (Chicago, IL)
- …Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: PB Revenue Integrity **Work Type:** Full Time ... as well as internal equity and industry specific market data . The pay range for each role reflects Rush's...case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for… more
- Norstella (Springfield, IL)
- …querying and analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), and other real-world data ... Norstella's newest service offerings leveraging Norstella's unified Real World Data asset, a combination of claims , lab,...data into structured formats suitable for analysis, ensuring data quality and integrity throughout the process… more
- Walmart (Evanston, IL)
- …area in accordance with company policies and procedures by properly handling claims and returns utilizing equipment to perform a variety of merchandising functions ... fulfillment process when necessary by processing information for thirdparty insurance claims rescanning illegible images alerting patients to inventory that is out… more
- Norstella (Springfield, IL)
- …the demand for Norstella's newest service offerings leveraging Norstella's unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and ... databases, ensuring data accuracy and quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data , to… more
- AbbVie (Mettawa, IL)
- …+ Professional training in a healthcare field, experience in analysis of large medical claims datasets or prior experience in the UNIX/Hadoop environment ... theories, analytical methods, and technical programming skills to analyze clinical, survey, claims , and electronic medical record databases. Role supports the… more
- Rush University Medical Center (Oak Park, IL)
- …care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or ... as well as internal equity and industry specific market data . The pay range for each role reflects Rush's...Federal, State, and local laws and regulations, Rush University Medical Center's Organizational Integrity Program, Standards of… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …lead the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity . The leader will be responsible for providing a compelling ... authorities, facilitating Clinical and PV inspections and addressing any findings. + ** Data Integrity :** Ensure the accuracy, consistency, and reliability of… more
- Rush University Medical Center (Chicago, IL)
- …care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting, or ... as well as internal equity and industry specific market data . The pay range for each role reflects Rush's...Federal, State, and local laws and regulations, Rush University Medical Center's Organizational Integrity Program, Standards of… more
- CVS Health (IL)
- …perform root cause analysis, and recommend improvements to enhance reporting accuracy and data integrity . + Stay informed about changes in Medicaid policy, ... investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate...findings to non-technical audiences. + 2+ years experience interpreting medical claim data + Advanced experience in… more