- 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 a **Corporate Credentialing Associate Specialist ** . This role is remote and can be worked from a variety of locations within ... credentialing database necessary for processing of recredentialing applications. + Reviews claims payment systems to determine provider status, as necessary. +… more
- Molina Healthcare (Milwaukee, WI)
- …processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's ... Degree **Preferred Experience** * Six years proven analytical experience within an operations or process-focused environment. * Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this position,… more
- Centers for Independence (Milwaukee, WI)
- **Program Integrity Specialist - ILIFE** **Job Details** **Job Location** iLIFE Main - Milwaukee, WI ** Remote Type** Fully Remote **Position Type** Full Time ... - Social Services **Description** **Job Purpose:** The Program Integrity Specialist is responsible for analyzing processes, incident reporting, communications, and… more
- TEKsystems (Milwaukee, WI)
- …needed + insurance + Medicare experience needed + group insurance + benefit interpretation + claims Pay: + $17 to $18.25 Training: + Monday to Friday + 8am to 4pm ... 8:30am to 5pm + 9am to 5:30pm Location: + Remote in the state of Wisconsin Pay and Benefits...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
- Elevance Health (Waukesha, WI)
- …Group Clinical Validation Auditor-RN** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims … more
- Gilead Sciences, Inc. (Milwaukee, WI)
- …purpose of this role is to serve as a field-based, product access specialist that partners with provider organizations to optimize patient access to Gilead PBC/Liver ... coverage, multi-channel acquisition pathways, billing and coding (as needed), claims processing, reimbursement, and awareness of manufacturer support programs into… more
- Molina Healthcare (Milwaukee, WI)
- **_ Remote and must live in the United States _** **Job Description** **Job Summary** Molina's Provider Contracting function provides guidance, signature support ... analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member… more