Clinical Benefits Specialist
Community Care - Milwaukee, WI

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Job Summary: Under the supervision of the Utilization Review Manager, with a matrix reporting relationship to the Enrollment Department Director, configures and maintains claims management system benefit structures for all programs to ensure accurate member benefit coverage resulting in accurate claims payment. Provides support and guidance to the Enrollment Department in applying correct benefit coverage to individual members as well as following CMS and DHS regulatory guidelines to ensure CCI is in compliance with all enrollment and disenrollment contract requirements. Location: 1555 S. Layton Blvd., Milwaukee

Hours: Full-time. 8:00am to 4:00pm

Travel: Occasional travel between Community Care and provider sites required.

Education: Bachelors Nursing or Related Healthcare Field preferred. If possesses an RN Degree. then would need a current WI RN license.

Experience: A minimum of 3 years configuring and maintaining medical claim system benefit structures and coordinating benefits with a bachelor's degree in a related field required. Or a minimum of 5 years of the specified experience. Claim check experience preferred.

Community Care - 20 months ago - save job - block
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About this company
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At Community Care, we aim to create the best possible experience for older adults. We believe that providing quality care can enable older...