• Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Milwaukee, WI)
    …relevant education and experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects from concept to ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability… more
    Molina Healthcare (08/14/25)
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  • CIRV Technologist -or- CIRV Radiology Technologist…

    Marshfield Clinic (Eau Claire, WI)
    …provided by the American Heart Association. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES) ... Heart Association within three months of hire. Registered Invasive Cardiovascular Specialist (RCIS) or Registered Cardiac Electrophysiology Specialist (RCES)… more
    Marshfield Clinic (08/13/25)
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  • Senior Coding Data Quality Auditor, Coding Quality…

    CVS Health (Madison, WI)
    …the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + Experience with International Classification of Disease (ICD)… more
    CVS Health (08/24/25)
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  • Delaware Valley ACO Fellowship

    Humana (Madison, WI)
    …accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and ... Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (07/30/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (WI)
    …with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered… more
    Banner Health (07/30/25)
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  • Appointment Coordinator - Behavioral Health

    Marshfield Clinic (Eau Claire, WI)
    …a vocational technical Health Unit Coordinator Program, Medical Office Specialist , Medical Secretary. **EXPERIENCE** **Minimum Required:** Excellent written and ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more
    Marshfield Clinic (08/30/25)
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  • Supervisor, Credentialing - Remote

    Molina Healthcare (WI)
    …Experience: * 4-years' experience in Credentialing. * Required knowledge of Medicaid , CMS, NCQA and other credentialing regulations. * Experience leading employees, ... skills. Required License, Certification, Association: Preferred Certified Provider Credentialing Specialist (CPCS) or, participation in a CPCS progression program.… more
    Molina Healthcare (08/28/25)
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  • Coordinator, Dental Program (Must reside near…

    Molina Healthcare (Kenosha, WI)
    …dental services, assist members with locating a general or specialist dentist, accessing appointments, translation services, and transportation assistance. ... experience is required + Previous dental, case management, pediatric, and/or Medicaid managed care experience is preferred **Required Competencies / Knowledge /… more
    Molina Healthcare (08/28/25)
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  • Claims Processor (with Facets) - Healthcare Remote

    Cognizant (Madison, WI)
    …is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate adjudication of ... UB/institutional (CMS-1450) and/or professional (CMS 1500) claims * Knowledge of Medicare/ Medicaid payment and coverage guidelines and regulations. * 1 year of… more
    Cognizant (08/26/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Madison, WI)
    …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... with secondary insurance company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Mails all paper claims. + Acts… more
    Cardinal Health (08/24/25)
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