- Molina Healthcare (Kenosha, WI)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... communication skills. * Microsoft Office suite/applicable software program(s) proficiency. ** Preferred Qualifications** * Customer/provider experience in a managed care… more
- Molina Healthcare (Milwaukee, WI)
- …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... codes, etc. + Access and Excel - intermediate skill level (or higher) ** Preferred Education** Bachelor's Degree ** Preferred Experience** + 5+ years managed care… more
- Molina Healthcare (Madison, WI)
- …tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources ... * Microsoft Office suite and applicable software programs proficiency. ** Preferred Qualifications** * Claims recovery experience. * Health insurance experience… more
- Novo Nordisk (Wausau, WI)
- …impact + Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... experience working in one or more of the following areas preferred : Pharmaceutical/Healthcare, Sales, Consulting, Customer Service or Military + Intermediate… more
- Molina Healthcare (Milwaukee, WI)
- …Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional ... oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School… more
- Humana (Madison, WI)
- …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... to an organization focused on continuously improving consumer experiences ** Preferred Qualifications** + PharmD + Health Plan experience +...+ PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma… more
- CVS Health (Madison, WI)
- …pre-certification, and predetermination of covered benefits in the commercial, Medicare , and Medicaid environment. This Wheelchair DME consultant provides subject ... and correct application of Aetna policies and practices for commercial, Medicare , and Medicaid environments. ◾Proactively use data analysis to identify opportunities… more
- Molina Healthcare (Green Bay, WI)
- …cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
- Molina Healthcare (Madison, WI)
- …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... Care Management & Waiver Service Auditing experience is highly preferred . Work hours: Monday - Friday 8:00am - 4:00pm...+ Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee… more
- Marshfield Clinic (Eau Claire, WI)
- …Accreditation._ **Minimum Required:** High school diploma or equivalent. ** Preferred /Optional:** Associate degree in related field. **EXPERIENCE** **Minimum ... able to take call for the department upon completion of orientation. ** Preferred /Optional:** Experience as a Technologist in a Cardiac Cath Lab, Electrophysiology… more