- Molina Healthcare (WI)
- …+ Health claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims ... and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution… more
- CVS Health (Madison, WI)
- …multiple health plan clients across multiple lines of business including Medicare, Medicaid , Exchange, and Commercial. This is a remote role, open to qualified ... understanding of CVSH clinical portfolio, marketplace segments dynamics (Medicare, Medicaid , Exchange, and or Commercial) and industry trends + Demonstrated… more
- Marshfield Clinic (Wisconsin Rapids, 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
- Cognizant (Madison, WI)
- …features. * Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory requirements. **Work Model:** We strive to… more
- CVS Health (Madison, WI)
- …and predetermination of covered benefits in the commercial, Medicare, and Medicaid environment. This Wheelchair DME consultant provides subject matter expertise in ... application of Aetna policies and practices for commercial, Medicare, and Medicaid environments. ◾Proactively use data analysis to identify opportunities for quality… more
- Cognizant (Madison, WI)
- …features. . Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other...processes for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA). . Strong understanding of CMS, ACA, and… more
- CVS Health (Madison, WI)
- …practice experience. Two (2) + years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA recognized specialty is ... we have an Integrated plan. Experience with managed care (Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of Medicine) or DO (Doctor… more
- R1 RCM (Milwaukee, WI)
- …to meet their financial obligations. Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in ... completing assistance program applications and determine eligibility and coverage. Notify manager, physician and servicing department of possible delay of service… more
- Molina Healthcare (Oshkosh, WI)
- …sales and marketing of Molina Medicare products to dual eligible, Medicare- Medicaid recipients within approved market areas to achieve stated revenue, profitability, ... the product choices available to them, the enrollment process ( eligibility requirements, Medicare review/approval of their enrollment application, timing of… more
- Ascension Health (Brookfield, WI)
- …Tuition reimbursement Ways to give back to your community _Benefit options and eligibility vary by position. Compensation varies based on factors including, but not ... care, such as those for certification, licensure and accreditation, Medicare, and state Medicaid . + Participate in all aspects of the CMS survey process including… more