- Molina Healthcare (Milwaukee, 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 ... also entails producing audit reports for internal and external review . The position may also work with other internal...+ Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of… more
- Marshfield Clinic (Minocqua, 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
- Marshfield Clinic (Marshfield, WI)
- …a resource to the care team with regards to discharge planning, and provides review of medical utilization to third party payers to obtain certification for the ... experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a clinic/hospital setting.… more
- Marshfield Clinic (Eau Claire, 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
- Datavant (Madison, WI)
- …vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring ... + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology,… more
- AO Smith (Milwaukee, WI)
- …+ Implement and manage legal holds + Assist with document collection, review and organization + Update insurers, claims administrators, and internal finance ... maintain litigation document databases as needed + Responsible for all MMSEA ( Medicare , Medicaid and SCHIP Extension Act) reporting of settlements in personal injury… more
- Fresenius Medical Center (Waupaca, 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
- Evolent (Madison, WI)
- …provider and vendor contracting, compliance, population health (including utilization management), Medicare , and Medicaid. + Draft, review and negotiate ... President, Deputy General Counsel, the Attorney will prepare and review a variety of complex contracts and provide legal...of legal terms to promote efficiency. + Draft and review significant correspondence and other documents on behalf of… more
- Marshfield Clinic (Marshfield, 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
- Marshfield Clinic (Rice Lake, WI)
- …are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Pharmacy ... are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._ **Minimum… more