- 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
- 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 (Racine, 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
- Molina Healthcare (Racine, 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 (Racine, 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
- 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
- Sedgwick (Milwaukee, WI)
- …Best Workplaces in Financial Services & Insurance Operations Support Services Specialist **PRIMARY PURPOSE** : To support Operations Support Services leadership ... an accredited college or university preferred. **Experience** Three (3) years claims management experience or equivalent combination of experience and education… more
- Molina Healthcare (Racine, 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
- CDM Smith (Racine, 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
- AO Smith (Milwaukee, WI)
- Benefits Specialist Date: Oct 8, 2025 Location(s): Milwaukee, WI, US, 53224-9508 Company: A. O. Smith Corporation Company / Location Information AO Smith is a global ... the Netherlands, and the United Kingdom. Primary Function As the Benefits Specialist , you will provide assistance with the administration of benefit programs… more
- Walgreens (Greenfield, 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
- CDM Smith (Racine, WI)
- …ID:** 40481BR **Business Unit:** FSU **Job Description:** The FEMA Costing Specialist : * Conducts preliminary damage assessments (PDAs) in the field for ... structure damaged by a disaster. * Reviews, evaluates and analyzes applicant-provided cost claims for reasonableness and accuracy as related to the scope of work. *… more
- CDM Smith (Racine, WI)
- …**Business Unit:** FSU **Job Description:** The FEMA Disaster Management Construction Specialist : * Schedules and conducts site inspections with applicants, performs ... projects and meets regularly on the status. * Evaluates applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates… more
- Molina Healthcare (Racine, 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 (Racine, WI)
- …and timely validation and maintenance of critical provider information on all claims and provider databases (using SQL, Excel, and QNXT). Staff ensure adherence ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- Molina Healthcare (Racine, 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
- Elevance Health (Waukesha, WI)
- …an accommodation is granted as required by law._ The **Patient Enrollment Specialist Team Lead** is responsible for providing technical direction, guidance, and ... resources to claims , customer service, or membership associates on a day-to-day basis. **How you will make an impact:** + Serves as a first line resource for… 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
