• Certified Medical Coder

    Ascension Health (Glendale, WI)
    …prior to hire date or job transfer date. All specialties accepted. + Certified Professional Coder (CPC) credentialed from the American Academy of Professional ... Registration: + One or more of the following: + Certified Coding Specialist (CCS) credentialed from the American Health...date or job transfer date. All specialties accepted. + Coder specializing in Cardiac credentialed from the American Academy… more
    Ascension Health (11/18/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (Milwaukee, WI)
    …applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... a RN with experience with appeals, claims review, and medical coding. **Job Summary** Provides support for medical...Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional… more
    Molina Healthcare (09/06/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Milwaukee, WI)
    …setting. * Completion of a health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina ... determine appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per… more
    Molina Healthcare (11/15/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Milwaukee, WI)
    …setting experience. * Completion of a health care related vocational program (ie, certified coder , billing, or medical assistant). To all current ... according to state, federal and Molina guidelines. * Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research.… more
    Molina Healthcare (11/15/25)
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  • Manager, Appeals & Grievances

    Molina Healthcare (Milwaukee, WI)
    …setting. * Completion of a health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina ... 1 year management/leadership experience. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims, Stop Loss,… more
    Molina Healthcare (11/13/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Milwaukee, WI)
    …setting. * Completion of a health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina ... **Provider No Surprise Act** cases outcomes. . * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per… more
    Molina Healthcare (11/09/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Milwaukee, WI)
    …software program(s) proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... Central time Remote position **Essential Job Duties** * Performs clinical/ medical reviews of previously denied cases in which a... Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional… more
    Molina Healthcare (11/14/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Milwaukee, WI)
    …software program(s) proficiency. **Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified ...(CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ). To all current… more
    Molina Healthcare (11/13/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (Milwaukee, WI)
    …Association** Licensed registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's ... ability to present those findings. **Preferred License, Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred +… more
    Molina Healthcare (10/22/25)
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  • DRG Coding Auditor

    Elevance Health (Waukesha, WI)
    …Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing… more
    Elevance Health (10/25/25)
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  • Specialist-Clin Documentation

    Ascension Health (Muskego, WI)
    …Association (AHIMA) obtained prior to hire date or job transfer date. + Certified Professional Coder (CPC) credentialed from the American Academy of Professional ... **Responsibilities** Facilitate improvement in overall quality, completeness and accuracy of medical record documentation. + Complete admission reviews and assigns a… more
    Ascension Health (09/30/25)
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  • Director, Clinical Data Acquisition

    Molina Healthcare (Milwaukee, WI)
    …Health Quality (CPHQ) * Nursing License (RN may be preferred for specific roles) * Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you ... supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all… more
    Molina Healthcare (10/22/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Waukesha, WI)
    …Requirements:** + Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for… more
    Elevance Health (11/04/25)
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