- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Pharmacy Systems Support Specialist Senior **Cost Center:** 301641560 System Ancillary Region-340b Admin **Scheduled ... of America) **Job Description:** **JOB SUMMARY** The Pharmacy Systems Support Specialist Senior helps facilitate and support the design, development, implementation… more
- Molina Healthcare (Milwaukee, WI)
- Molina Healthcare is hiring a Supervisor, Member Outreach, Training Specialist . This remote role will have a focus on spearheading, facilitating much of the training ... Experience: + Background Training + Managed Care background and/or is familiar with Medicare and Medicaid. + Process based, + Able to build forms and trainings… more
- Molina Healthcare (Milwaukee, WI)
- …with the standards and requirements established by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal ... to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists with interdepartmental issues… more
- Robert Half Accountemps (Milwaukee, WI)
- Description We are looking for a skilled Medical Billing Specialist to join our team on a 12-week contract in Milwaukee, Wisconsin. In this role, you will play a ... * Ensure compliance with insurance regulations and government guidelines, including Medicare and Medicaid policies. * Collaborate with clinical and administrative… more
- SSM Health (Madison, WI)
- …️ **Deliver Care Behind the Scenes-Join SSM Health as a Medical Equipment & Supply Specialist !** ️ Make a real impact in a **full-time role (40 hrs/week)** with a ... and prior authorization for appropriate equipment/supplies. + Ensures compliance with Medicare , Medicaid and Accreditation Standards. + Works in a constant state… more
- Mayo Clinic (La Crosse, WI)
- …Competitive retirement package to secure your future. **Responsibilities** The HME Specialist I position is the first of multiple career opportunities within ... service. Must be able to work independently as needed. Knowledge of Medicare , Medicaid and/or private insurance billed preferred with attention to detail. Physical… 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 Medical, Supplemental, and pharmacy… more
- Molina Healthcare (Milwaukee, WI)
- …to determine if providers have sanctions/exclusions. * Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes daily NPDB Continuous Query reports and takes appropriate action when new reports are found. **JOB QUALIFICATIONS** **Required… more
- Highmark Health (Madison, WI)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- SSM Health (Fond Du Lac, WI)
- …a working knowledge of all The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS) Conditions of Participation and State Hospital Licensing ... of continual readiness related to The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participations (CoPs) and State specific… more