- 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
- Marshfield Clinic (Weston, WI)
- …exciting missions in the world!** **Job Title:** Clinical Pharmacy Specialist **Cost Center:** 301691245 WesHos-Pharmacy-Inpatient **Scheduled Weekly Hours:** 40 ... (United States of America) **Job Description:** **JOB SUMMARY** The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize the care of… more
- Prime Therapeutics (Madison, WI)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- SSM Health (Fond Du Lac, WI)
- …Highlights:** **We're Hiring!** SSM Health is seeking a **Medical Equipment and Supply Specialist ** to join our **Continuum of Care** team at the **Agnesian Health ... and development Location: Agnesian Health Shoppe, WI Apply here: https://ssmh.wd5.myworkdayjobs.com/ssmhealth/job/WI-Agnesian-Health-Shoppe/Medical-Equipment-and-Supply- Specialist --Continuum-of-Care\_R178388-1 Tag someone who'd be a great fit or… more
- Cognizant (Madison, WI)
- …on the review of clinical documentation in accordance with Medicare, Medicaid , and third-party guidelines. . Effectively document and log claims/appeals information ... offers the following benefits for this position, subject to applicable eligibility requirements: * Medical/Dental/Vision/Life Insurance * Paid holidays plus Paid… more
- Molina Healthcare (Green Bay, WI)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicare claims and appeals processing,… more
- SSM Health (Madison, WI)
- …provide medical equipment and supplies. + Verifies patient insurance eligibility /benefits and communicates financial responsibilities to patients, caregivers, and ... and prior authorization for appropriate equipment/supplies. + Ensures compliance with Medicare, Medicaid and Accreditation Standards. + Works in a constant state of… more
- Humana (Beloit, WI)
- …payer sources, providers, and interdisciplinary care teams. + Educates members in maintaining Medicaid eligibility . + Assist with entry of annual Level of Care ... help us put health first** The Care Coach 2 (Transition/Custodial Prevention Specialist ) assesses and evaluates member needs and requirements to achieve and/or… more
- St Croix Hospice (Eau Claire, WI)
- …patients, completes physical and face-to-face assessments, and evaluates hospice eligibility as assigned in consultation with the hospice interdisciplinary team. ... required face-to-face assessments for hospice recertification and provides clinical eligibility information to the medical director. + Ensures effective symptom… more
- Cardinal Health (Madison, WI)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work ... and properly resolves by follow-up & disposition. + Verifies patient eligibility with secondary insurance company when necessary. + Bills supplemental insurances… more