Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Group Medicare Sales & Service Executive will be responsible for acquiring, implementing, and retaining Group Medicare accounts and plan members. The role

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Workers Compensation Senior Claims Representative Job Locations US WI West Bend | US WI Waukesha | US IN Indianapolis | US MI Detroit ID 2024 2047 Category Claims Position Type Regular Remote/Hybrid Hybrid Company Overview Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at Wes

You will be a great fit for this role if You are highly engaged in innovative clinical practice and prioritize excellent patient care You are motivated and excited to lead a high performing team of clinically focused pharmacists You are flexible and work well in a fast paced environment You enjoy and can demonstrate independent decision making and problem solving skills Y

Maintains, confirms and secures referrals, authorization, or pre certifications required for patients to receive physician or medical services. Verifies the accuracy and completeness of patient account information. Maintains database of payer authorization requirements. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicai

Customer Care Sales Representative Commercial Lines Job Locations US WI West Bend | US WI Madison | US WI Appleton ID 2024 2074 Category Service Center Position Type Regular Remote/Hybrid No Company Overview Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at West Bend, where w

This role will have all responsibilities of coder I, II and III in addition to reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD 10 CM/PCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EM

EXCELLENT LOCAL OPPORTUNITY!

EXCELLENT LOCAL OPPORTUNITY!

Assure equitable claim service is performed in a timely manner involving commercial surety claims. Interpret bond language to determine company liability on commercial claims. Identify issues that need to be escalated. Coordinate the investigation of commercial surety claims and evaluate resolution options. Utilize information gathered to establish and maintain appropriat

Supervise direct reports, make recommendations for performance management and disciplinary action. Train subordinates to achieve goals. In addition, contribute to the new employee selection process. Supervise the claims department workflow. Distribute and allocate work to ensure efficient and timely processing of claims. Develop and maintain standard operating procedures

This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic support for all Blue Cross NC Medicare products with a particular emphasis on Medicare Part D. You will identify and evaluate risks and strategic opportunities involving Blue Cross NC's Medicare business through the deployment of actuarial co

Provide support for sales and service team as assigned by Manager. Duties will include, but may not be limited to items below. Mail/Scanning Facilitate process to get all paperwork into our systems including carrier website policy retrieval, scanning incoming mail, downloading from carrier emails. Bind and distribute paperwork to insureds/staff – per written workflo

Prepare consolidation of monthly P&L vs. plan/LBE/ PY, including volume, manufacturing cost, financial bridges, and historical trends. Assist in the month end financial close of assigned components of the P&L including identification and resolution of unusual items in a timely manner. Serve as a trusted partner to the manufacturing organization by articulating, reviewing,

Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL (LB&I) DIVISION? A description of the business units can be found at Vacancies will be filled in the following specialty areas Large Business and International Director Enterprise Activities The following are the duties of this position at the full working level. If this vacancy includes more than one grade and you are s