• Medical Billing Specialist

    Robert Half Accountemps (Milwaukee, WI)
    …you will play a key part in ensuring the accuracy and compliance of healthcare claims processing , supporting timely reimbursements and maintaining high ... offers an excellent opportunity to contribute your expertise in a dynamic healthcare environment. Responsibilities: * Review and analyze patient accounts and billing… more
    Robert Half Accountemps (08/19/25)
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  • Senior Claim Benefit Specialist - Stop Loss…

    CVS Health (Madison, WI)
    …by the stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with ... This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider… more
    CVS Health (08/23/25)
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  • Specialist, Configuration Oversight…

    Molina Healthcare (Kenosha, WI)
    …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication **PHYSICAL DEMANDS:** Working environment is… more
    Molina Healthcare (08/16/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Kenosha, WI)
    …Experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing /resolution, including ... Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility… more
    Molina Healthcare (07/18/25)
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  • Claims Processor (with Facets)…

    Cognizant (Madison, WI)
    …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Must ... ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**...is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for… more
    Cognizant (08/22/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Waukesha, WI)
    …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... The ideal candidate has experience working in leading healthcare payer claims / revenue cycle management (RCM) organizations, with specific understanding in… more
    Elevance Health (08/14/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Madison, WI)
    …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a… more
    Cognizant (08/01/25)
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  • Senior Analyst Pricing - Remote

    Prime Therapeutics (Madison, WI)
    …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare , and/or related field + Previous experience ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
    Prime Therapeutics (08/13/25)
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  • Pricing Analyst Sr - Strong SQL/GCP - Remote

    Prime Therapeutics (Madison, WI)
    …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare , and/or related field. + Previous experience ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
    Prime Therapeutics (08/01/25)
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  • Medicaid State Technology Lead

    Humana (Madison, WI)
    …payor operations, technology, communications, and processes + Solid understanding of healthcare operations, particularly around claims processing , ... make an impact** **Required Qualifications** + Bachelor's degree in healthcare administration, public health, information systems, business, policy administration or… more
    Humana (08/19/25)
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