- 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
- 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
- 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
- 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
- Lundbeck (Deerfield, IL)
- …IC, cross functionally. + Delivers ad hoc analysis, as needed, for review with senior management. + Investigates and resolves data related field inquiries in a ... Intelligence reporting tools (Qlik, Power BI, Tableau) + Knowledge of pharmaceutical data (ie retail/ non-retail, specialty pharmacy, payer, claims , etc.) +… more