- Prime Therapeutics (Madison, WI)
- …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...department are achieved. + Works with Quality and Training specialist to refine and improve any processes that effect… more
- 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
- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
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