- Molina Healthcare (Milwaukee, WI)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- Marshfield Clinic (Wisconsin Rapids, WI)
- …months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall ... hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services at time of hire. **Marshfield Clinic Health System is… more
- Prime Therapeutics (Madison, WI)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to ... management experience + Knowledge of the applicable line of business (eg, Medicare , Medicaid , Exchange, Commercial, Employer Group) Every employee must… more
- Humana (Madison, WI)
- …Finance + Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare / Medicaid experience + Data architecture/solution architecture experience + ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Humana (Madison, WI)
- …determine, and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Prime Therapeutics (Madison, WI)
- …processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid , and Health Insurance Marketplace for the assigned ... regulations into operational requirements **Preferred Qualifications** + 2 years Medicare Part D, Medicaid , and/or state or...Qualifications** + 2 years Medicare Part D, Medicaid , and/or state or federal regulatory experience + Prior… more
- Humana (Madison, WI)
- …day to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid , and/or and Group Account members and create actionable ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Cognizant (Madison, WI)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA), ensuring compliance with CMS, ACA, and ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA). * Strong understanding of CMS, ACA, and… more
- Cognizant (Madison, WI)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA), ensuring compliance with CMS, ACA, and ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid , ACA). . Strong understanding of CMS, ACA, and… more
- Humana (Madison, WI)
- …Coder + Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more