- 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)
- …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
- Zurich NA (Brookfield, WI)
- …landscape by helping them manage and mitigate risk, improve safety and reduce claims and associated costs. These services add an important layer of protection for ... Engineering experience within the insurance industry + Certified Fire Protection Specialist (CFPS) + Strong communication and consultative skills + Outstanding… 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