- Sedgwick (Madison, WI)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
- Ryder System (Madison, WI)
- …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 3 manages claims operations that ... all claim settlements both for and against the organization. The Claims Research & Resolution Representative 3 performs advanced… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support ... & LTC hospice patients and reconcile historic billing issues. **Location: Remote US** **Shift: Monday-Friday 2:30pm-11pm EST. Flexibility to work alternating… more
- Molina Healthcare (Madison, WI)
- **_ Remote and must live in Wisconsin _** **Job...2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working ... familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc. **PREFERRED EDUCATION** :… more
- Prime Therapeutics (Madison, WI)
- …decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting ... levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team +...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- United Therapeutics (Madison, WI)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
- HealthEdge Software Inc (Madison, WI)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Madison, WI)
- …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
- HealthEdge Software Inc (Madison, WI)
- …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Madison, WI)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more
- HealthEdge Software Inc (Madison, WI)
- …solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a ... permanent **Work Environment:** The physical demands described here are representative of those that must be met by an...Work across multiple time zones in a hybrid or remote work environment. + Long periods of time sitting… more
- Intermountain Health (Madison, WI)
- …each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, ... functions. + Ability to work with technical accuracy and in a remote atmosphere + Demonstrated ability to multitask between computer and multi-communication… more