Medical Coding Policy SME - Remote Wisconsin Gainwell Technologies LLCMedical Coding Policy SME - Remote WisconsinWIRemote$64,500–$85,000 / yearThis role is responsible for reviewing and evaluating CPT, HCPCS, and ICD-10 coding updates, supporting MMIS-related initiatives, researching complex policy and coding questions, and partnering with internal and external stakeholders to ensure coding guidance, system configuration, and reimbursement policies remain accurate and compliant. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
Medical Coding Specialist - Outpatient (full-time) Sauk Prairie HealthcareMedical Coding Specialist - Outpatient (full-time)WisconsinRemoteRequired: Must obtain credentials through the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) in any of the following certifications within six months of date of hire and maintain such credential thereafter: Registered Health Information Technician (RHIT) or Administrator (RHIA). Reviews medical reports and physician documentation for clinic and hospital outpatient services in order to apply diagnostic and procedural codes to individual patient health information for claims processing, data retrieval and analysis.
Coding Denials Specialist - Clinical Practice Services Medical College of WisconsinCoding Denials Specialist - Clinical Practice ServicesWisconsinConducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is needed. The individual is responsible for resolving coding claim edits, coding-related claim denials & coding correspondence, monitoring for trends and assist in the analysis, development, and implementation of solutions to minimize avoidable denials and adjustments.
Coding Quality Analyst - Clinical Practice Services Medical College of WisconsinCoding Quality Analyst - Clinical Practice ServicesWisconsinAssist in performing medical coding audits on clinicians and/or coding staff as needed within multi-specialty physician practices to identify deficiencies and ensure coding remains compliant with coding guidelines as well as government and third-party payer regulations and guidelines. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.
NewSenior Director Coding Sanford HealthSenior Director CodingMarshfield, WI$67–$110.50 / hourCollaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Facility: Marsh Main Location: Marshfield, WI Address: 1000 N Oak Ave, Marshfield, WI 54449, USA Shift: 8 Hours - Day Shifts Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $67.00 - $110.50.
Coding Audit Specialist, Health Plan Sanford HealthCoding Audit Specialist, Health PlanWisconsinThe Coding Audit Specialist position conducts quality assurance activities to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and Department of Health Services (DHS); identifies deficiencies and provides management with an analysis of outcomes and tools for improving accuracy in coding. Responsible for auditing medical record documentation to determine appropriate diagnostic coding for services provided, taking into account the AMA CPT coding guidelines, ICD‐9 & ICD‐10 Coding Guidelines, CMS Medicare, HHS, and DHS BadgerCare Plus risk adjustment policy and Hierarchical Condition Category Coding.
Engineer III - CICD Code Signing Automation (Remote) CrowdStrike IncEngineer III - CICD Code Signing Automation (Remote)WIRemote$120,000–$180,000 / yearAbout the Role: On the Engineering Systems team at CrowdStrike, we operate and maintain many of the systems and services that support the build, test, signing, and deployment of our software to the cloud and to our customers, as well as providing consultation, troubleshooting, and engineering support for the creation and maintenance of the pipelines that provide those functions. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
Payment Integrity Policy Analyst QuartzPayment Integrity Policy AnalystWisconsin$72,500–$90,600 / yearFull timeQualifications: Bachelor's degree with 2+ years of payment integrity, coding integrity or revenue integrity experience OR associate degree with 5+ years of payment integrity, coding integrity, or revenue integrity experience. Overview: If you’re passionate about medical coding accuracy, payment integrity, and making a meaningful impact on healthcare affordability and quality, this is your opportunity to make a difference for our members and providers.
Physician Assistant / Nurse Practitioner - New Wisconsin Rapids Location GI AssociatesPhysician Assistant / Nurse Practitioner - New Wisconsin Rapids LocationWisconsin Rapids, WIFull timeThis role delivers high-quality, efficient, and cost-effective care to patients and their families within our clinics, playing a key part in ensuring continuity, clinical excellence, and an exceptional patient experience.*Occasional coverage and training at our Wausau & Stevens Point locations may be required. Advanced clinical knowledge of the GI system, pharmaceuticals, and GI related diagnostic testing (lab and radiology).Knowledge of location, care, operation, and safety hazards of medical equipment, instruments, and procedures to administer effective, safe patient care.
Physician Assistant / Nurse Practitioner - New Wisconsin Rapids Location GI Associates SCPhysician Assistant / Nurse Practitioner - New Wisconsin Rapids LocationWisconsin Rapids, WIThis role delivers high-quality, efficient, and cost-effective care to patients and their families within our clinics, playing a key part in ensuring continuity, clinical excellence, and an exceptional patient experience. Maintains clinic schedule that maximizes patient access to appointment (including outreach locations) and designed to meet productivity targets as defined by the clinic.
Revenue Management Educator - Health Plan Sanford HealthRevenue Management Educator - Health PlanMarshfield, WI$26–$41.50 / hourThe Educator provides overall educational support and coding quality assurance activities to both internal and external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Services (DHS). Facility: Marsh Security Hlth Plan Location: Marshfield, WI Address: 1515 N St Joseph Ave, Marshfield, WI 54449, USA Shift: Day Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $26.00 - $41.50.
Hospice Nurse Practitioner Gentiva Health Services Inc (Inactive)Hospice Nurse PractitionerStevens Point, WIComplete all visit types for patients on services, including Medicare-required hospice Face-to-Face (F2F) visits within CMS established regulatory timeframes, History & Physical/Initial Comprehensive visits, Problem-focused Symptom Management visits, Admission visits, Goals of Care discussions, and routine follow up visits. The Nurse Practitioner will deliver advanced clinical care, perform patient management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with physicians and interdisciplinary teams to ensure high-quality, compliant, and compassionate care.
Informatics Consultant CVS Health CorpInformatics ConsultantWI$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Field Reimbursement Manager-Ophthalmology – Minnesota, Wisconsin Regeneron PharmaceuticalsField Reimbursement Manager-Ophthalmology – Minnesota, WisconsinWisconsinProactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers. Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.
AUTHORIZATION SPECIALIST - KRONENWETTER CLINIC Aspirus IncAUTHORIZATION SPECIALIST - KRONENWETTER CLINICMosinee, WIThe health system operates 18 hospitals and 130 outpatient locations with nearly 14,000 team members, including 1,300 employed physicians and advanced practice clinicians. Aspirus Health is a nonprofit, community-directed health system based in Wausau, Wisconsin, serving northeastern Minnesota, northern and central Wisconsin and the Upper Peninsula of Michigan.
Provider Network Data Integrity Analyst - Health Plan Sanford HealthProvider Network Data Integrity Analyst - Health PlanWisconsinResponsible for completion of network adequacy filings for Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), Department of Health Services (DHS), and requested employer groups. Audits and advises provider credentialing on identified data issues, including working with delegated credentialed entities, to ensure that complete and accurate information is being received.
Sales Manager CloudbedsSales ManagerWisconsinRemoteYou will be responsible for identifying and acquiring new business opportunities, building strong relationships with prospects, and showcasing how Cloudbeds’ industry-leading SaaS solutions are transforming the hospitality space. Since our founding in 2012, we've become the World's Best Hotel PMS Solutions Provider and landed on Deloitte's Technology Fast 500 again in 2024, but we're just getting started.
Senior Manager, Market Access & Reimbursement GE HealthCare Technologies IncSenior Manager, Market Access & ReimbursementWIRemote$145,600–$218,400 / yearThis role will develop and execute payer engagement strategies, influence coverage decisions, and drive patient access through strong partnerships with payers, providers, and internal stakeholders. Collaborate with Evidence Generation/HEOR and Clinical teams to deliver compelling value propositions, clinical evidence, and economic models to payers and providers.
Hospice Nurse Practitioner Heartland HospiceHospice Nurse PractitionerStevens Point, WisconsinFull timeComplete all visit types for patients on services, including Medicare-required hospice Face-to-Face (F2F) visits within CMS established regulatory timeframes, History & Physical/Initial Comprehensive visits, Problem-focused Symptom Management visits, Admission visits, Goals of Care discussions, and routine follow up visits. The Nurse Practitioner will deliver advanced clinical care, perform patient management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with physicians and interdisciplinary teams to ensure high-quality, compliant, and compassionate care.
Physician Assistant/Nurse Practitioner - Primary Care (Brown Deer) Rogers Memorial HospitalPhysician Assistant/Nurse Practitioner - Primary Care (Brown Deer)WisconsinRBH offers adults, as well as child and adolescent patients in our communities, the ability to receive care at multiple level of services including: inpatient, residential, partial hospitalization, intensive outpatient and outpatient services. In this role, with the support of a collaborating physician, the provider will primarily serve as a hospitalist in our inpatient and residential departments, and working alongside our psychiatric providers in a multi-faceted treatment team model of providing care.