- Cognizant (Madison, WI)
- …billing, with strong knowledge of RARC and CARC codes. . Expertise in Medicare , Medicaid, Managed Care, and Commercial payer processes. . Deep understanding of ... reporting. . Excellent verbal and written communication skills for documentation and appeals . . Ability to meet productivity and quality standards in a fast-paced… more
- Molina Healthcare (WI)
- …* Provides second level behavioral health clinical reviews, peer reviews and appeals . * Supports behavioral health committees for quality compliance. * Implements ... compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation… more
- Cardinal Health (Madison, WI)
- …the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes ... regulations, or third party policy. + Updates patient files for insurance information, Medicare status, and other changes as necessary or required. + Keeps email… more
- Humana (Madison, WI)
- …program; and work closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD + Leads BH policy ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Baylor Scott & White Health (Madison, WI)
- …leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key contract enforcement activities. + Collaborates ... (CBS) and other revenue cycle departments to streamline referral and appeals workflows. + Supports education and training initiatives to improve documentation… more