- Banner Health (WI)
- …Inpatient Facility Coding department. If you have experience with DRG and PCS coding/ denials /audits, we want to hear from you. **Requirements:** + **5 years recent ... proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials , billing edits/rejections to provide coding expertise to resolve issues and… more
- Cardinal Health (Madison, WI)
- …system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + Processes denials ... judgement in any changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or… more
- Ascension Health (Cudahy, WI)
- …Notifiy case management about interactions with insurance companies regarding services. + Manage denials or potential denials as described by insurer. + Monitor ... and review applicable schedule to ensure that authorization and initial length of stay is obtained and on file. **Requirements** Education: + High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. + Note: Required… more
- Molina Healthcare (Milwaukee, WI)
- …and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals ... and denials . + Strong verbal and written communication skills To all current Molina employees: If you are interested in applying for this position, please apply… more
- Cardinal Health (Madison, WI)
- …products leverage data analysis and workflow automation to prevent claim denials , streamline enrollment in patient assistance programs, and optimize hospital-managed ... to medications. They also help healthcare systems minimize claim rejections and denials , navigate patient assistance programs, and reduce the cost of providing care… more
- Ascension Health (Wauwatosa, WI)
- …+ Provides appropriate documentation that meets insurance company requirements; appeal all denials in a timely manner. + Participates in inpatient and outpatient ... consultation for specialty, which may include on call schedules. **Requirements** Licensure/Certification/Registration: **Required Credential(s):** + BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date. American HeartAssociation or… more
- Humana (Madison, WI)
- …put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical ... documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs… more
- Ascension Health (Union Grove, WI)
- …+ Provides appropriate documentation that meets insurance company requirements; appeal all denials in a timely manner. + Participates in inpatient and outpatient ... consultation for specialty, which may include on call schedules. **About Ascension All Saints Hospital** + Non-for-profit, community hospital with 350 licensed beds + Diverse patient population, serving the community since the 1870s + Over 200 employed… more
- Amgen (Madison, WI)
- …payer policies and processes (eligibility and benefit verification, prior-authorization and appeals/ denials ) + Improve use of marketing resources to maintain and ... develop customer relationships for the purpose of growing the customers' confidence to prescribe Amgen medications for appropriate patients + Communicates territory activity in an accurate and timely manner as directed by management + Provides feedback to… more
- Ascension Health (Milwaukee, WI)
- …+ Provides appropriate documentation that meets insurance company requirements; appeal all denials in a timely manner. + Participates in inpatient and outpatient ... consultation for specialty, which may include on call schedules. **About Ascension Milwaukee Hospitals** + As a member of Ascension Milwaukee Hospitals, our physicians join a large community of providers who are called to deliver compassionate, personalized… more