- CVS Health (WI)
- …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states: Arizona, California, Florida, Illinois, ... Director will be a "Work from Home" position primarily supporting the Aetna Oklahoma Medicaid plan and the UM team; but part of a centralized team that supports… more
- Mayo Clinic (Eau Claire, WI)
- …deductibles, and co-insurance. In addition, the counselors may assist patients with Medicaid , Third Party eligibility and Charity Care applications and ... processing. Responsible for establishing payment plans and collecting true self-pay and self-pay residual balances as necessary. Responsible for assisting patients with ad-hoc financial issues as needed prior to, during and following their treatment at Mayo… more
- Mayo Clinic (Menomonie, WI)
- …the appropriate consents as required. May assist patients with hospital presumptive eligibility or Medicaid applications. In person registration requires the ... ability to physically walk to patients' location throughout the emergency department and/or hospital. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance… more
- CenterWell (Madison, WI)
- …community and help us put health first** A **Director of Authorizations & Eligibility ** is a senior revenue cycle leader responsible for the strategic oversight, ... operational execution, and continuous improvement of all authorization, insurance eligibility re-verification and payer maintenance for a large, complex Home Health… more
- Molina Healthcare (Kenosha, WI)
- …claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims ... the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and… more
- Gentiva (Sheboygan, WI)
- …+ Understanding of palliative medicine principles, home health, hospice care eligibility , and Medicare/ Medicaid regulations. + Familiarity with the ... interdisciplinary care process. + Meets mandatory continuing education requirements for Gentiva and licensing boards. + Proficient in point-of-care software and technology. **Education/Experience:** + Master of Science in Nursing from an accredited school of… more
- Good Samaritan (WI)
- …and support to all operating segments across Sanford. Responsible to review Medicare/ Medicaid documentation to assist nursing centers in completing minimum data set ... (MDS) documentation to assure appropriate levels of Medicare and/or Medicaid reimbursement. Works with executive leadership, administrators, and facility staff in… more
- Marshfield Clinic (Weston, WI)
- …and determine level of financial assistance award, and medication assistance eligibility , according to protocol. The Patient Assistance Counselor maintains a ... + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training offered after… more
- CVS Health (WI)
- …developing and maintaining complex financial reporting solutions that support Aetna's Medicaid Markets. This role will lead reporting for Value-Based Service ... tables, formulas, and graphs. **Preferred Qualifications** + Experience working with Medicaid and Medicare programs. + Advanced Excel skills (complex formulas,… more
- Cognizant (Madison, WI)
- …Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid , and private insurance plans. + _Adjudication:_ Approve, deny, or ... equivalent REQUIRED + Strong knowledge of US healthcare insurance systems (Medicare, Medicaid , commercial payers). + 2-4 years of experience in US healthcare claims… more