- Parexel (Madison, WI)
- **Project Lead,** **Meeting Services** We are looking for a Meeting Specialist to join our talented and supportive team of 40+ delivering high quality international ... . Completes timesheets on time . Completes/approves project related expense claims **Metrics for success** . Utilization/billability target . Contribution to… more
- GAP Solutions Inc (Madison, WI)
- **Position Objective:** As a Junior Human Resource Specialist , apply HR skills in support of managers, program staff and customers on the full range of HR topics ... Assisting with drafting SOP's. + Processing personal liability insurance reimbursement claims . + Initiating tentative selection notifications, notice of results or… more
- Morley (Madison, WI)
- …**_Questions Before You Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 7 am - 4 pm Central ... time sensitive **_Nice to Have_** + Experience in medical claims reimbursements or medical billing + Conversant in health...Patient advocacy: Free 24/7 help with benefit questions and claims issues + Family, financial and estate guidance (will)… more
- Zurich NA (Madison, WI)
- Marine Claims Senior Claims Specialist 126574 Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and ... and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Juris Doctor...and 2 or more years of experience in the Claims and/ or Litigation Management area.OR + Zurich Certified… more
- Artera (Madison, WI)
- Claims Specialist Summary Title: Claims Specialist ID:1773 Location:Madison, 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
- Molina Healthcare (Madison, WI)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. + Maintains and reconciles department reports for… more
- Sedgwick (Madison, WI)
- …Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims ... and RESPONSIBILITIES** + Performs standard clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information… more
- Molina Healthcare (Madison, 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
- TEKsystems (Madison, WI)
- …+ Resolve billing errors/edits, including accounts with Stop Bills and "DNBs" to ensure all claims are filed in a timely manner + Ensure all claims are ... documentation is sent when required + Verify eligibility and claims status on unpaid claims + Review payment denials and discrepancies and take appropriate… more
- Molina Healthcare (Madison, 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
- Parexel (Madison, WI)
- …and improve patient outcomes. We are seeking a passionate and experienced **RWE** Specialist join our team and support the design and execution of clinical trials ... environment and is driven by innovation and scientific rigor. **Title:** RWE Specialist **Location:** Remote - US **Key Responsibilities** + Understand and be… more
- Sedgwick (Madison, WI)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including… more
- Molina Healthcare (Madison, 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
- Molina Healthcare (Madison, 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
- Cognizant (Madison, WI)
- **Member Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We are ... seeking a dedicated Member Appeals & Grievance Specialist with a minimum of 2 years of experience...and Grievance experience Minimum of 2 years of medical claims processing experience (Must be with a healthcare plan,… more
- CDM Smith (Madison, 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
- Walgreens (Stoughton, 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
- Prime Therapeutics (Madison, WI)
- …and drives every decision we make. **Job Posting Title** Customer Care Specialist **Job Description** This position is a front-line service position providing ... Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities… more
- Carrington (Madison, WI)
- …completes the Set-up bankruptcy filings process, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition ... the set-up bankruptcy filings, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition Fee notices, Payment… more
- Molina Healthcare (Madison, 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
