- Wipfli LLP (Milwaukee, WI)
- …reviewing skilled nursing Medicare cost reports, understanding the skilled nursing Medicaid reimbursement systems for assigned states, assisting clients with ... the respective service area, region or industry, the Manager, Provider Compliance & Reimbursement is responsible for...reports + Gain an understanding of the skilled nursing Medicaid reimbursement systems for the assigned states… more
- Humana (Madison, WI)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Madison, WI)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
- SSM Health (WI)
- …requested to support filings. + Assists with compilation of data for annual Medicaid disproportionate share hospital surveys and audits. + Compile and submit ... a calling.** WI-REMOTE **Worker Type:** Regular **Job Highlights:** **Government Reimbursement Financial Analyst Senior** + Provides all government reimbursement… more
- Option Care Health (Madison, WI)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Humana (Madison, WI)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- Molina Healthcare (WI)
- …and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and ... **JOB DUTIES** + Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to… more
- Mayo Clinic (Eau Claire, WI)
- **Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to US News & World Report. As we work together to put the ... Highlights** + Medical: Multiple plan options. + Dental: Delta Dental or reimbursement account for flexible coverage. + Vision: Affordable plan with national… more
- Gentiva (Stevens Point, WI)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... full-time position providing face to face visits. We are looking for someone to provide visits in Adams County, Waushara County, Marquette County or Wood County. We… more
- Mayo Clinic (La Crosse, WI)
- …Southwest Wisconsin again received a 5-star rating from the Centers for Medicare & Medicaid Services for Overall Hospital Quality. Five stars is the highest ... is top-ranked in more specialties than any other care provider according to US News & World Report. As...Medical: Multiple plan options. + Dental: Delta Dental or reimbursement account for flexible coverage. + Vision: Affordable plan… more
- CVS Health (Madison, WI)
- …payment policy. The Wheelchair DME consultant provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna ... clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential.… more
- Oracle (Madison, WI)
- …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
- Molina Healthcare (Green Bay, WI)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (WI)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Racine, WI)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- Gentiva (Fond Du Lac, WI)
- …designated teams and functions as an interdisciplinary (IDG) team member to provide care and liaise between physician, patient/family and hospice team. + Performs ... minimum of one (1) year experience as an RN, either in acute care hospital , oncology, long-term care, hospice or home health. + In instances where state-specific… more
- Humana (Madison, WI)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more
