- BrightSpring Health Services (Milwaukee, WI)
- …basic mathematical calculations (eg, converting milligrams) + May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale ... (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and keep management informed of unpaid claims and claims pending follow-up + Provides excellent customer service to external and internal customers in… more
- Aveanna Healthcare (Madison, WI)
- …or instruction. + Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective ... communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff. + Supervises other personnel (PTA, HHA) as applicable. + Completes OASIS assessments where allowed by state professional practice and… more
- Ascension Health (Racine, 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
- Aveanna Healthcare (Shawano, WI)
- …or instruction. + Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective ... communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff. + Supervises other personnel (OTA, HHA) as applicable. + Completes OASIS assessments where allowed by state professional practice and… more
- Intermountain Health (Madison, WI)
- …+ Oversees the day-to-day revenue cycle functions including claims processing, denials , payments, customer service, and follow up on accounts. Oversees adjustments, ... insurance processing and verification, accuracy of billing and payment posting. Monitors workflow to ensure timely processing. Collaborates with department leadership team to evaluate service needs and volumes and adjust staffing levels accordingly. Assigns… more
- Molina Healthcare (Racine, WI)
- …reported accurately to maintain compliance and to minimize risk and denials . **KNOWLEDGE/SKILLS/ABILITIES** + Performs on-going chart reviews and abstracts diagnosis ... codes + Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly + Documents results/findings from chart reviews and provides feedback to management, providers, and office staff… more
- Humana (Madison, WI)
- …the impactable drivers of prior authorization and look at appeals rate with denials and overturns. Deliver the upmost consistent medical director decision making. + ... _Internal Operations and Technology_ _:_ Support efforts to improve the efficiency of health plan operations (utilization management and provider clinical contracting) to reduce friction for members, providers, and associates. + _External Partnerships_ _:_… 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
- Aveanna Healthcare (Eau Claire, WI)
- …or instruction. + Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers + Maintain effective ... communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff. + Supervises other personnel (OTA, HHA) as applicable. + Completes OASIS assessments where allowed by state professional practice and… more
- Evolent (Madison, WI)
- …obtain additional pertinent clinical history/information; notifies of approvals and denials , giving clinical rationale, while providing optimum customer service ... through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by… more