- 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
- 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
- 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
- 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
- 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)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- Elevance Health (Waukesha, WI)
- **Recovery Specialist Associate** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... cost containment company offering subrogation recovery services. The **Recovery Specialist Associate** is responsible for identifying, tracking, and reconciling… more
- Molina Healthcare (Milwaukee, WI)
- …Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider (or authorized ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine Medicare appeal and claim outcomes.… 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
- 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
- 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
- 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
- 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
- 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
- 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)
- …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
- Acosta Group (Franklin, WI)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Molina Healthcare (Milwaukee, WI)
- …support for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit ... Duties** * Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been… more
