Medical Claims Specialist Jobs in Wisconsin
Are you looking for temp to hire work? Are you available on first shift, Monday through Friday? Do you have experience processing claims? If so, SPHERION has a GREAT opportunity for you!! Our West Madison client has multiple openings to put your experience to use in their beautiful office! This position has full-time hours, Monday through Friday. Again, this is a Temp to Hire opportunity. Candi...
This is a full-time position located at 222 W. College Ave in Appleton, WI. This is a full-time position working on claims for Network Health Plan. The Claims Resolution Specialist is responsible for all aspects of Facility and Provider Billing, research and patient account resolution on Insurance pending balances for all Commercial/Contracted Payers. This position is also the primary resource a...
MINISTRY HEALTH CARE WI
Description Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. it drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Claims Coding Specialist who will maintain the unique rules customization of the claims adjudication software. Stay current with coding changes to apply s...
Responsibilities: Uphold the highest level of service orientation toward all customers and comply with awesome customer service telephone expectations including “Mountain Standard Time (after regular hours)” coverage. Process initial file set-up of Personal and Commercial Lines claims; check entry and correct errors. Assign and reassign losses to appropriate claims representative, make first cont...
Ministry Health Care Menasha, WI, 54952
Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. it drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Claims Coding Specialist who will maintain the unique rules customization of the claims adjudication software. Stay current with coding changes to apply specified codi...
We are looking for qualified candidates to fill a Medical Billing/AR Specialist Job in Waukesha, WI. In order to be considered for this role you must have at least two years’ recent billing/accounts receivable experience within the medical field. Majority of this position will be handling the claim processing from beginning to end. You must be familiar with Medicare Part B and private insurance bi...
If you believe every job can impact the customer, let’s talk. When you choose a career at Dean Health Plan, the relationships you build with our members, agents, employer groups, health care providers and even your fellow employees will establish the foundation for your professional growth and Dean Health Plan’s continued success. Embracing values, such as teamwork honesty, trust, excellence and r...
The Claims Specialist position is resonsible for conducting the tracking and filing for all reinsurance filings for all commercial, self-funded and governmental (Senior Preferred) and submission to the reinsurance carrier according to designated timeframes. Performs claim adjudication for all transplant and high dollar claims based on contractual and benefit information. This position will assist ...
CUNA Mutual Group Madison, WI, 53706
Work Location: Madison, WI We are seeking an uncommon professional to join our team as a Sr. Claim Professional. Job Purpose This professional level claim specialist conducts the review and investigation, liability determination, and management of short term and long term disability claims. This position acts independently and autonomously managing the claim by conducting a thorough review and ...
Description Wausau Manor Nursing Home is seeking qualified Registered Nurses (RN) to provide dedicated, compassionate service to the residents in our skilled nursing care / rehabilitation center in the role of Clinical Reimbursement Specialist (MDS Nurse). Summary: Under the direction of the Clinical Reimbursement Coordinator (CRC, MDS RN) responsible for the coordination of the Resident Assess...
Responsibilities: Set up claim files and verify coverage Assign new losses to Claims Representatives Process claim checks Answer general claims questions or forward calls to the appropriate contact Process incoming and outgoing mail Maintain the paperless filing system Resolve medical-only claims Provide superior customer service for all internal and external customers Review and analyze payment ...
Employers Holdings, Inc. Brookfield, WI, 53005
As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work! We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS®! Headquartered in Reno, Nevada, EMPLOY...
Medical College Of Wisconsin Milwaukee, WI, 53201
**This position is being posted to solicit applications from candidates seeking positions in medical billing. Candidates with previous medical billing, and follow up experience are strongly preferred. This is not an open position, however candidates that apply to this position will be contacted as applicable positions come open** POSITION IDENTIFICATION Position Titl e: Account Representative II...
MINISTRY HEALTH CARE Stevens Point-Occupational Health, WI
Description Ministry Medical Group-Employer Solutions is looking for an enthusiastic self-starter to join their team as a full-time Billing Specialist! Ministry Health Care-Employer Solutions provides comprehensive, integrated occupational health services to businesses and the employees who make them great. Our full range of services include drug and alcohol testing and program management, injur...
Berkshire Hathaway Travel Protection Stevens Point, WI, 54492
This position is primarily responsible for the creation and management of Berkshire Hathaway Travel Protection’s claims operation. We are seeking a candidate with a strong desire to create a new claims operation that focuses on providing exemplary service to claimants by leveraging both new technologies and customer advocacy. Description Essential Duties and Responsibilities include the followin...
The Claims Examiner is responsible for accurate and timely adjudication of claims for all Gundersen Health Plan product lines. Primary duties include analysis and resolution of claims, including coding principles, benefits, pricing and potential third party liability. The Claims Examiner must be able to work independently, effectively prioritizing work in production environment that frequently cha...
Molina Healthcare Inc West Allis, WI
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor s...
Molina Healthcare West Allis, WI, 53214
Job Summary The Medical Records QA Specialist will review medical records and performs assessments to determine errors in the records. Essential Functions • Skilled use of HEDIS software for data entry, over reading, QA queries • Reviews medical records to ensure standards are met as defined by NCQA , Molina, and external auditor. • Identifies standards met and gaps against external auditor sta...
Repair Center Manager Up to $90,000 per year, based on experience Uline – Shipping Supply Specialists "The people I work with are as passionate as I am." "I came to Uline for a job. Instead, I found a career." Uline is North America's leading distributor of shipping, packaging and industrial supplies. We're a family-owned company known for our incredible customer service and quality products....
The OSI Group is a results-oriented global company where highly talented, motivated, "can-do" people work together to deliver value for our customers. Our success is built on a foundation of partnership with our customers, suppliers and employees and is what sets us apart. At OSI you will be challenged to solve problems and drive improvements that will help grow our business. Reporting to the Gen...
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Healthcare Career Tools
Medical Claims Specialist/Examiner
$24,000.00 - $52,000.00
Typical Salary for Medical Claims Specialist/Examiner in Wisconsin
Source: Monster.com Careerbenchmarking Tool
Education / Training
Some College Coursework Completed
Source: Monster.com Careerbenchmarking Tool
Medical Claims Specialist/Examiner
Processes medical claims by reviewing and analyzing information; determining actions such as acceptance or denial.
Rate of Growth
Size of Industry in 2006:
Source: Bureau of Labor Statistics, May 2006
Determines covered medical insurance losses by studying and interpreting contracts and policies.
Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
Popular Medical Claims Specialist Articles
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