- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …territory plans through partnerships with internal and external stakeholders + Review and educate offices on payer policies, including prior authorization ... in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially... & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in "Buy and Bill"… more
- Cardinal Health (Madison, WI)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Madison, WI)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Marshfield Clinic (Marshfield, WI)
- …is to ensure positive customer interacts with one major product line ( Medicare Advantage or Commercial/Marketplace) of Security Health Plan's members. The individual ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- St Croix Hospice (Wausau, WI)
- …Communication + Communicates and collaborates with the interdisciplinary group to create, review and revise the patient's plan of care. + Consults with the ... Additional Duties + Maintains knowledge of and compliance with current Medicare /Medicaid, state/federal rules and regulations for hospice services + Ensures… more
- Molina Healthcare (WI)
- …care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... The position also entails producing audit reports for internal and external review . The position may also work with other internal departments, including Compliance,… more
- Marshfield Clinic (Waupun, WI)
- …within the department 4. Assists in policy and procedure development and review 5. May participate in interviews **Position will float to various clinics** ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- Marshfield Clinic (Menomonie, WI)
- …are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more
- Prime Therapeutics (Madison, WI)
- …and expansion products within the vendor suite of solutions + Responsible to review dashboard and provide timely reporting of all required metrics; validate accuracy ... problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) regulations, client issues and quality… more
- Fresenius Medical Center (Milwaukee, WI)
- …the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ... appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and… more
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