- Sedgwick (Madison, WI)
- …accredited college or university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner . Familiar with CPT, DRG and resources ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do… more
- Sedgwick (Madison, WI)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (Sun Prairie, WI)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Molina Healthcare (Milwaukee, WI)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Prime Therapeutics (Madison, WI)
- … claims processing environment **Preferred Qualifications** + Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) + National ... and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively… more