- Molina Healthcare (Kenosha, WI)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- The Hartford (Chicago, IL)
- Sr Data Scientist - GD07AE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... Step into the future with The Hartford as a Data Scientist / Sr Data ...Join a team that's pioneering AI-driven solutions in underwriting, claims processing, and customer service, transforming how we operate… more
- The Hartford (Chicago, IL)
- Sr Data Scientist - GD07AEData Scientist - GD08AE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages ... Step into the future with The Hartford as a Data Scientist / Sr Data ...Join a team that's pioneering AI-driven solutions in underwriting, claims processing, and customer service, transforming how we operate… more
- Molina Healthcare (Kenosha, WI)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Elevance Health (Chicago, IL)
- **Business Consultant Sr (Configuration Lead)** **Carelon Services** **International Operations** **Hybrid 1:** This role requires associates to be in-office 1 - 2 ... adaptable workplace. Alternate locations may be considered. The **Business Consultant Sr .** is responsible for translating most highly complex and varied business… more
- Molina Healthcare (Kenosha, WI)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Axis (Chicago, IL)
- …specialty insurers + A good working knowledge of the workstreams, workflows, processes, and claims systems , in aP&C claims organization, for both North ... multiple departments. The Product Owner would focus on managing and enhancing claims -related products, systems , and processes. Their role involves translating… more
- Lundbeck (Deerfield, IL)
- Senior Data Scientist AI Strategy and...motivated, and highly experienced individual for the position of Sr . Data Scientist AI Strategy & Activation. ... MLOps for model deployment. + Familiarity with version control systems , such as Git. + Ability to tackle complex...+ In-depth experience working with pharmaceutical datasets (first-party patient data , third-party claims , EHR, demand data… more
- CVS Health (Northbrook, IL)
- …of UiPath, Automation Anywhere (AA), or other RPA tools + 3+ years analyzing claims data and/or other large datasets + 3+ years converting business requirements ... action, and have experience in design thinking, continuous process improvement, systems analysis, solution architecture and development, and data integration.… more
- Bank of America (Chicago, IL)
- …detection algorithms and systems . Perform regular audits and analysis of transaction data to detect new fraud trends. * Guiding team to Develop new fraud ... Fraud Analytics and Innovation Senior Leader - Client Protection Newark, Delaware;Plano, Texas;...data required for performing analysis. * Partner with claims , policy, strategy, and product teams to deliver … more
- Molina Healthcare (Kenosha, WI)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Zurich NA (Chicago, IL)
- …to support senior management in developing and improving processes and systems relevant to underwriting. + Assess complex customer cases, evaluate their unique ... Market Facing Domestic Casualty Supporting Lines Senior Underwriter 123760 Zurich is currently looking for...the organization's risk and compliance processes. + Research primary data sources, select relevant information, analyze key themes and… more
- Abbott (Abbott Park, IL)
- …+ Minimum 9 years of related work experience. + Experience using big data is required, preferably with prescription, medical claims and/or longitudinal ... way patients and professionals measure, track and analyze glucose levels. As a Senior Manager, Market Access Analytics, you will support advanced analytics for the… more
- AbbVie (Mettawa, IL)
- …Industry - Forecasting, Pricing or FP&A * Experience with US healthcare industry-standard data sets (eg IMS/Quintiles (IQVIA) claims , NPA Rx, 867 and 852 ... Tok (https://www.tiktok.com/@abbvie) . Job Description Primary Job Function: This Finance Senior Manager is responsible for end-to-end Volume & Revenue forecast for… more
- Surgery Care Affiliates (Chicago, IL)
- …tools that support key enterprise initiatives + Load, cleanse, and analyze externally-sourced claims data , combining with internal data sources to develop ... a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without… more
- Walgreens (Libertyville, IL)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- HUB International (Des Plaines, IL)
- …by developing relationships with others **S** **ummary** The Employee Benefits Senior Account Manager works collaboratively with the Team Leads, Producer, and ... Provides benchmarking reports to client (annually, quarterly, or monthly) + Manages claims and coverage issue resolution for clients' employees when elevated from… more
- WESCO (Chicago, IL)
- As a Senior Administrator - Customer Care you will be responsible for completing administrative daily tasks for assigned large and/or complex location in accordance ... the location. + Documents and submits individual task KPI data used for process improvement. + Assists Customer Care...when appropriate. + Works with Financial Services to clear claims . + Adds new customers into WESNET and PACT… more
- Revlon (Chicago, IL)
- …Associate Business Manager, collects business, point of sale, and market trend data and analyzes to determine new business opportunities + Pro-actively works with ... vs. plan to ensure budget adherence + Processes account claims on an on-going and timely basis + Manages...understanding of programs, customer needs, and competitive activity. + Systems Skills + Advanced Word, Excel, PowerPoint, and Adobe… more
- Snapsheet (Chicago, IL)
- …engineering output with business goals. + Champion scalable and stable solutions for our data pipelines and reporting systems . + Work closely with BI analysts, ... Job Title: Engineering Manager - Data Company: Snapsheet Job Location: USA, Remote Job...and technology to enable the fastest and most accurate claims processing in the industry. About the Role +… more