Provide leadership and oversight of Disability Income claims operations, ensuring claims are being administered in compliance with applicable state laws and regulations. Manages teams that both administer claims and support claims through recruitment, selection, training, development, motivation, and salary administration of staff. Primary Duties & Responsibilities Respon

Investigate all non standard claim problems (25%) Investigates for COB and determine the primary payer (25%) Investigate and process adjustment requests (25%) Adjust claim payments resulting from duplicate payments, incorrect payee, etc. Recover expended funds for managed care plans System documentation of investigation results Training of Coordination of Benefits claim p

At Children's Wisconsin, we believe kids deserve the best. Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family res

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