- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Milwaukee, WI)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Liability **PRIMARY PURPOSE** : To process low level ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Sedgwick (Madison, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Humana (Milwaukee, WI)
- …put health first** Are you ready to make a meaningful impact in the world of healthcare claims ? As a Claims Representative 2, you will play a vital role in ... for adjustments + Cross trained in multiple areas within the Claims Department + Review and update internal policies and procedures as needed + Provide… more
- Sedgwick (Sun Prairie, WI)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative , Total Loss | Remote **PRIMARY PURPOSE** : To analyze ... and process low to mid-level auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property damage and lower level injury … more
- Ryder System (Madison, WI)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- SSM Health (Madison, WI)
- …or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job ... component of a patient's obligation using the third party claims processing and payment rules. Bills claims ...+ Works on special projects as needed. + May review the work of others. + Performs other duties… more
- Molina Healthcare (Kenosha, WI)
- …requirements and expectations, setting provider goals and plans for regular review , identifying knowledge and service gaps, and offering support for resolution. ... monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with...3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3+… more
- Highmark Health (Madison, WI)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Festival Foods (WI)
- …available programs related to various lines of insurance are fully utilized. + Review company policies and emerging trends within claims to determine coverage ... to meet department objectives. Provides direct leadership to the Senior Claims Specialist and Workplace Safety Specialist. Prepares and delivers direct reports'… more
- Ryder System (Madison, WI)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Highmark Health (Madison, WI)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (Madison, WI)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- ITW (Appleton, WI)
- …to manage all aspects of incident response. + Serve as corporate technical representative during incident reporting, field inspections, and claims management. + ... safety design reviews and risk assessments across the product lifecycle. + Review and approve product precautionary labeling for accuracy and compliance. + Evaluate… more
- Prime Therapeutics (Madison, WI)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- AZCO (Appleton, WI)
- …and consult with the Legal Department as required. + May lead review , negotiation, approval, and execution of prime contracts, subcontracts, and change orders. ... request for information (RFI's), submittals, change management, contract closeout, and claims mitigation. + Analyze and approve internal and external reports… more
- RxBenefits (Milwaukee, WI)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more
- Packing Corp of America (Tomahawk, WI)
- …physician to provide medical services to employees. + Serve as company representative for Employee Assistance Program, ADA, FMLA, Workers Compensation, short term ... prevention, and detection. Maintains wellness boards monthly with fresh topics. + Review , update, and maintain essential job function reports. + Responsible for… more