- Molina Healthcare (Kenosha, WI)
- …with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and requests for ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare, Marketplace and/or other government-sponsored program), or medical… more
- Marshfield Clinic (Wisconsin Rapids, WI)
- …previous customer service experience, patient registration, authorization or billing . Demonstrated leadership skills and demonstrated proficiency with written ... and verbal communications. Knowledge of commercial and government billing requirements. **Preferred/Optional:** Previous office leadership experience. **CERTIFICATIONS/LICENSES** _The… more
- CVS Health (Madison, WI)
- …state, federal and company requirements are met and recognize any concerning billing patterns or trends. **Activities include:** + Conduct a comprehensive medical ... review findings. + Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc.… more
- Vatica Health (Milwaukee, WI)
- …in critical care (ie, ICU/CCU/MICU) and/or ED) + Proficiency with Diagnosis, Billing , and Quality Measures Coding a plus + Excellent interpersonal skills that ... advanced practice providers and medical office personnel such as Practice and Billing Manager, both verbally and written + Understanding of health insurance benefit… more
- Gentiva (Milwaukee, WI)
- …of palliative medicine principles, home health, hospice care eligibility, and Medicare/ Medicaid regulations. + Familiarity with the interdisciplinary care process. + ... in Family or Adult Medicine preferred. + Experience with Part B billing . + Ability to work autonomously in an advanced practice role.… more
- Molina Healthcare (Milwaukee, WI)
- …them navigate and get the most out of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. You can learn more ... large part of the position, which includes assisting participants with provider billing , seeking support brokers, tracking receipts, ensuring their workers are paid… more
- Humana (Madison, WI)
- …complex data sets within large organizations + Experience working with Claims, Billing and Reconciliation or related healthcare data + Expertise in Microsoft Office ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Highmark Health (Madison, WI)
- …duties as specified. + Identify and report improper coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in ... formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across multiple states. They… more
- Cognizant (Madison, WI)
- …to referral, preauthorization, medical necessity, non-covered services, investigational/experimental and billing resulting in denials and/or delays in payment. . ... on the review of clinical documentation in accordance with Medicare, Medicaid , and third-party guidelines. . Effectively document and log claims/appeals information… more
- Molina Healthcare (Racine, WI)
- …into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced ... standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form). * Advanced understanding of key managed care concepts… more