- Molina Healthcare (Madison, WI)
- …programs. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims...audit , provider disputes, appeals, and 1500 & UB04 claim experience are highly preferred. Ability to apply state… more
- Sedgwick (Madison, WI)
- …; ensures appropriate recommendations are made on claims . + Consistently achieves appropriate quality audit scores. + Acts as clinical resource to claims ... of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Acts as a backup for… more
- American Family Insurance - Corporate (Madison, WI)
- As an Advertising Compliance Specialist , you will provides a full range of compliance oversight, advice and services with specialist knowledge in support of the ... on enacted changes in legislation and regulations to assist with sales, claims or product development and maintenance. * Collaborate with various business units… more