Detail of : CASE MANAGEMENT SPECIALIST, CMH - CLINICAL RESOURCE MGMT Job Opening in Menomonee Falls
Come join our award winning team! See What Is Possibleâ¦. The & the Medical College of Wisconsin regional health network is a partnership between Health and the Medical College of Wisconsin supporting a shared mission of patient care innovation medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma Center at Hospital Milwaukee an internationally recognized training and research center engaged in thousands of clinical trials and studies. The & MCW health network which includes five hospitals more than 1700 physicians and nearly 40 health centers and clinics draws patients from throughout the Midwest and the nation. Health has been widely recognized for our dedication to our staff providing a work environment full of encouragement innovation collaboration and respect. Our best-in-class wellness program has earned us recognition in the Milwaukee Business Journal as a Healthiest Employer and a Gold Well Workplace award from the Wellness Council of America. We invite you to review the job posting below. If you meet the requirements and qualifications for this opportunity you are encouraged to apply. Thank you for considering a career with Health! Location: US:WI:MENOMONEE FALLS at our FROEDTERT MEN FALLS HOSPITAL facility. FTE: 1.000000 *1.0 FTE is Full-Time any position less than 1.0 FTE is Part-Time and .001 FTE is Optional Part-Time* *Positions with an "FTE" (full time equivalency) of .81.0 are eligible for full-time medical dental and vision benefits. Positions with an "FTE" of .5.799 are eligible for part-time pro-rated medical dental and vision benefits* Shift: Shift 1
Work schedule: Monday-Friday 8am-4:30pm Summary: Responsible for initiating preauthorization of all patients assigned to a bed as needed. Faxes requested clinical documentation to UROs. Responsible for account conversion status changes and monitoring/correcting insurance information changes in EPIC. Other duties as assigned. Responsibilities: Minimum of four years of experience in a hospital setting which includes three years with hospital billing office and admitting experience is required. Experience/certification in health insurance and managed care programs is required. Minimum of two years of experience in Medicare and managed care denial management is preferred. High School diploma or equivalent is required. Completion of a medical terminology course through a college or technical institution is required. Related billing and clinical coding coursework is required. Other information: Microsoft Office applications Document Imaging HDX SMS PTIQ screens copy machines and fax machines; Knowledge of medical terminology. We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts recruits engages and retains a diverse workforce. As a federal contractor/subcontractor we take affirmative action in employment based on race sex disability and
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