- 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
- 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
- Lincoln Financial (Madison, WI)
- …this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will analyze… more
- CVS Health (Madison, WI)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Lincoln Financial (Madison, WI)
- …at a Glance** We are excited to bring on a Social Security Specialist to join our Financial Services Organization supporting Group Protection. Background Details ... used in conjunction with disability insurance policies. They will monitor claimants' SS claims until a final decision is received. **What you'll be doing** +… 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)
- 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 (Madison, 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 (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
- 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
- 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
- Walgreens (Madison, 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
- CVS Health (Madison, WI)
- …we do it all with heart, each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility ... documents. + Knowledge of Microsoft Excel. **Preferred Qualifications** + 1-2 years claims processing experience. + 1-2 years auditing experience. + Able to work… more
- Datavant (Madison, WI)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… 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
- 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
- Cardinal Health (Madison, WI)
- …to meet and exceed revenue and profitability objectives. The _Sr. Specialist , Business Intelligence_ provides Product & Solutions Marketing support to internal ... methodology and requirements gathering is a plus. + Basic understanding of operations and claims processing in pharmacy or other healthcare related area is a plus. +… more
- Molina Healthcare (Madison, 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
- Carrington (Madison, WI)
- …Bankruptcy Ledger Experience Required to be Considered!** The Bankruptcy Ledger Specialist will be responsible for completing and monitoring ledgers through the ... high degree of accuracy, for all Bankruptcy processes including Acquisitions, Proof of Claims , Notice of Final Cures, Motions for Relief, Agreed Orders, Notices of… more
- Robert Half Finance & Accounting (Portage, WI)
- Description We are looking for an experienced Accounting Specialist to join our team in Portage, Wisconsin. This role involves managing various accounting functions, ... and input statistical data for state reporting. * Compile and review grant claims while ensuring proper documentation. * Utilize Microsoft Excel and other Office… more
