ZipRecruiter

Log In

1

Claims Configuration Jobs in Chicago, IL

AArete

Consultant, Payment Intelligence

Chicago, IL

$49.50 - $67.75/hr

Knowledge of claims editing processes, including Prepay/Post-Pay, COB, Subrogation, Fraud Detection, and Medical Record Reviews * Contract Configuration& Provider Data Expertise * Interpretation of ...

SysMind Tech

Majesco Business Analyst

Chicago, IL · On-site

$85/hr

... configuration requirements, and developing an overall configuration approach for the client o ... Billing/Claims • Estimation • Reviewing end to end test strategy and cases for customer ...

Allied

Data Analyst - Data Ops

Chicago, IL · On-site +1

$50K - $55K/yr

... with file (claims, eligibility, extracts) implementations, supporting accurate configuration, testing, and transitions to production. * Support additional EDI, claims file, or data extract ...

Arvist Inc.

Customer Success Manager

Chicago, IL · On-site

$70 - $90/hr

Warehouses lose 2 to 10 percent of revenue to claims from damaged goods, labeling errors, and wrong ... Coordinate with our technical team to resolve configuration issues, integration questions, and ...

next page

Showing results 1-20

All JobsClaims Configuration JobsClaims Configuration Jobs in Chicago, IL

Sr Manager/Associate Director - Analytics Consulting (Healthcare)

Chicago, IL • On-site

Tiger Analytics Inc.
Business Management Consulting • 201 - 500 employees
Learn more about Tiger Analytics Inc.external

Full-time

Re-posted 9 days ago

Job description

Tiger Analytics is pioneering what AI and analytics can do to solve some of the toughest problems faced by organizations globally. We develop bespoke solutions powered by data and technology for several Fortune 100 companies. We have offices in multiple cities across the US, UK, India, and Singapore, and a substantial remote global workforce.

If you are passionate about working on business problems that can be solved using structured and unstructured data on a large scale, Tiger Analytics would like to talk to you. Now hiring for multiple opportunities in Technology Consulting and Solution Delivery.

Responsibilities

Requirement gathering - Work closely with clients and business SMEs to analyze pain points in the Medicare and Medicaid processes (with greater focus on claims management) and provide detailed information on business procedures, industry regulations, and user needs.

Evaluation and recommendation of use-cases - Evaluate and recommend AI, analytics, software, and engineering use cases to address client challenges with regards to complex business logics and user workflows.

Solution design - Provide critical insights and guidance to project teams, ensuring that the solution accurately reflects the complexities and nuances of Medicare and Medicaid domain (specifically focused on claims management), when developing products, systems, or processes. Partner with analytics and technology consulting teams to share insights on key processes, personas, and tools, ensuring alignment on effective solutions.

Validation and Review - Assess project deliverables, design documents, and test cases to ensure they align with domain knowledge and industry best practices.

Training and Knowledge management - Educate project teams on Medicare/Medicaid domain-specific concepts, jargon, and industry standards. Support the development of capability assets (including documents, demos) for the Medicare & Medicaid LOB within Tiger’s Consulting, DS, and Engineering Practice.

Requirements

  • 10-12 years of deep domain consulting experience.
  • Extensive understanding of US healthcare claims and Medicare and Medicaid industry and its specific regulations.
  • Chatbot/GenAI solution implementation for claims configuration
  • Handling MBR, QBR, estimation process involving budget, Production support.
  • Excellent analytical skills to identify potential issues and propose solutions by effectively conveying technical information to diverse teams.
  • Excellent problem solving and critical thinking skills with diligence.
  • Experience with managing stakeholder expectations to ensure effective communication and program success.
  • Ability to stay updated on industry trends and emerging technologies.
  • Masters/Bachelor of Science/Engineering, MBA preferred.
  • Healthcare certifications preferred.

Benefits

Significant career development opportunities exist as the company grows. The position offers a unique opportunity to be part of a small, fast-growing, challenging, and entrepreneurial environment, with a high degree of individual responsibility.

Tiger Analytics provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, national origin, ancestry, marital status, protected veteran status, disability status, or any other basis as protected by federal, state, or local law.