- Greenfield Rehabilitation Agency/Rehab Resources (Brookfield, WI)
- …Description Join Our Growing Team at Greenfield Rehabilitation Agency as a Billing Specialist ! Are you ready to make an impact? Greenfield Rehabilitation Agency is ... detail-oriented individuals to become part of our dynamic team! As a Billing Specialist at our corporate headquarters, you'll play a pivotal role in supporting… more
- Eisai, Inc (Milwaukee, WI)
- …profile, we want to hear from you. The Senior Oncology Sales Specialist is responsible for meeting/exceeding sales goals through promoting Oncology therapeutic ... assigned territory in a compliant and appropriate manner. The Senior Oncology Sales Specialist represents and promotes assigned brand(s) in the IV and oral markets… more
- Artera (Milwaukee, WI)
- Claims Specialist Summary Title: Claims Specialist ID:1772 Location:Milwaukee, WI Department:Legal More about this job > Description JOB PURPOSE: Manage ... all claims while under the general supervision of the Claims Director. Provide monthly updates and reporting. Coordination and database management; and other… more
- Rising Medical Solutions (Milwaukee, WI)
- The Claims Specialist will assist in reviewing, processing, and coordinating claims accurately in accordance with the program requirements while ensuring ... + Maintain ongoing knowledge of program requirements + Analyze and process claims for accuracy, eligibility, and benefits coverage + Retain and strengthen… more
- Molina Healthcare (Milwaukee, WI)
- Molina Healthcare is hiring for an Appeals & Grievance Specialist . This role is 100% remote and will work in the Pacific Time Zone. This role provides support for ... claims activities including reviewing and resolving member and provider...Experience:** + Call center experience + Be familiar with claims + Great computer and MS Office skills +… more
- Molina Healthcare (Milwaukee, WI)
- Molina Healthcare is hiring for a Medicare Appeals & Grievances Specialist . This position is remote and will be working Pacific Standard hours. Highly Qualified ... to detail + AOR/IRE understanding highly preferred Provides support for claims activities including reviewing and resolving member and provider complaints, and… more
- Molina Healthcare (Milwaukee, WI)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more
- Elevance Health (Waukesha, WI)
- Job Description **Recovery Specialist Associate** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration ... cost containment company offering subrogation recovery services. The **Recovery Specialist Associate** is responsible for identifying, tracking, and reconciling… more
- Molina Healthcare (Milwaukee, WI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Centers for Independence (Milwaukee, WI)
- **Billing Specialist II** **Job Details** **Job Location** CFI Main Campus - Milwaukee, WI **Position Type** Full Time **Education Level** High School Diploma, HSED, ... Percentage** None **Job Category** Finance **Description** **Job Purpose** : The Billing Specialist II is responsible for all facets of billing and collections for… more
- Molina Healthcare (Milwaukee, WI)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system configurations… more
- CDM Smith (Milwaukee, WI)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
- Centers for Independence (Milwaukee, WI)
- **Quality Assurance Specialist -iLIFE** **Job Details** **Job Location** iLIFE Main - Milwaukee, WI **Remote Type** Fully Remote **Position Type** Full Time ... - Social Services **Description** **Job Purpose** : The Quality Assurance Specialist ensures accurate, efficient document processing. This position is responsible… more
- Walgreens (Brookfield, WI)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Deloitte (Milwaukee, WI)
- …wants to work in a collaborative environment? As an experienced Epic Professional Billing Specialist , you will have the ability to share new ideas and collaborate on ... onsite client service delivery. Work you'll do/Responsibilities As a Project Delivery Specialist (PDS) at Deloitte, you will work within an engagement team and… more
- Molina Healthcare (Milwaukee, WI)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.… more
- Generac Power Systems (Waukesha, WI)
- …we continue to push new boundaries. The Senior Industrial Technical Support Specialist is responsible for providing advanced technical support to our authorized ... dealer personnel on how to navigate Generac's warranty systems and submit claims electronically. + Troubleshoots with the dealer technician to resolve highly complex… more
- Molina Healthcare (Milwaukee, WI)
- …to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists with interdepartmental issues ... **I** **E** **N** **C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service experience in a managed… more
- Molina Healthcare (Milwaukee, WI)
- …and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, ... + 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration. + 3+ years' experience in Medical Terminology,… more
- Molina Healthcare (Milwaukee, WI)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
