Account Manager

• Release of information: Reply to requests for information from insurance companies.
• Pull the appropriate medical records to submit for claims payment and ensure all proper documentation is present and accurate.
• Apply extensive knowledge of multiple contracts, agreements and government guidelines/regulations to submit, post, research and/or resolve accounts or claims.
• Communicate via phone with various representatives, both internally and externally is necessary.
• Analyze multiple sources of remittance to determine proper allocation of rejections, payments and/or adjustments, subject to individual carrier guidelines and contractual fee schedules.
• Respond to carrier requests for additional information or documentation.
• Review carrier denials and/or unacceptable reimbursement to (a) challenge the determination or (b) adjust appropriately.
• Review and update registration to correspond with information received from payer.
• Copy and forward remittance advice to appropriate team for follow-up.
• Responsible for identifying and escalating contractual carrier issues to the appropriate source.
• Assist training Clerks.
• Perform necessary billing activities such as claims to maintain team goals or assist other teams.
• Other duties as assigned.

Account Rep II – Clinical Practice Services

Communications

• Assist in oversight of the main mass email tool for departments’ internal use, making sure best practices are used, helping users troubleshoot, providing review of content and possibly helping train new users.
• Review, edit and publish all content provided by our hospital partners and other members of the Office of Communications to the MCW intranet.
• Help write new content as needed.
• Lead design, review and edit of institutional internal newsletters, such as the monthly In Good Health Newsletter, the quarterly Corporate Compliance Newsletter and/or the Weekly News Recap.
• Assist Internal Communications Team in executing institutional communications plans for annual events and initiatives, including but not limited to drafting content, setting up emails and/or creating design assets.
• Assist Internal Communications Team with making recommendations to departments on optimization of MCW intranet, internal mass email and other channels.
• Assist or lead content development supporting internal storytelling, marketing or instructional content to further pride, engagement and knowledge.
• Create and share analytics reports on main internal communications channels, including MCW intranet, mass email tool and digital media boards.
• Perform other duties as assigned.

Corporate Communications Intern

Backend Engineer

• Design, develop, and maintain scalable, API-first solutions that extend and integrate with enterprise platforms.
• Apply AI-assisted development practices to accelerate solution delivery, ensuring adherence to enterprise standards and security practices.
• Quickly convert concepts and ideas into solutions through detailed specifications.
• Analyze and modify existing business applications and processes, providing recommendations for improvements.
• Diagnose and resolve problems in the maintenance and support of business applications.
• Interact with client and technical teams to define requirements, resolve issues and develop solutions.
• Provide input when reviewing new business application designs to ensure consistency with business objectives and technical standards.
• Collaborate with the business and management teams to develop efficient plans and processes.

Java Developer II

Director

• Under the general supervision of the CFO, provide strategic leadership and expert oversight for all aspects of MCW’s payer relations and contracting.
• Develop and implement new and established contracts for professional services on behalf of the MCW Medical College Physicians adult specialty care practice.
• Lead negotiations with payers to include payment terms based on multiple reimbursement models.
• Evaluate rate proposals and changes to reimbursement methodologies to ensure financial viability of contracts.
• Develop and execute communication plans and payer negotiation outlines related to payer relationships and negotiations.
• Ensure contracts and proposals are properly entered into organizational database to measure, track, and monitor utilization and financial performance of managed care contracts.
• Assist CPS and internal customers with resolution of complex payer issues.
• Participate in leadership meetings with third party payers to address contractual payment issues and trends.

Director, Managed Care

Systems Engineer

• Supports the configuration and modification of general computer applications software or specialized utility programs for the student information system (Banner)
• Analyzes user needs and develops software solutions.
• Triaging and managing help desk tickets.
• Provides application technical support for assigned student information system modules and functions.
• Communicates with application vendors to debug, test, and resolve application failures.
• Participates in systems upgrades, modifications, and reconfigurations.
• Translates business requirements into business solutions; acts as liaison between departmental leaders, staff and information technology staff to design and configure business solutions
• Works closely with stakeholders to define business requirements and with technical staff to develop solution alternatives
• Coordinates IT troubleshooting and day-to-day activities within the department to ensure seamless and minimal downtime of hardware, software, and reporting requirements.
• Establishes test plans, test cases and executes testing.
• Prepares and maintains standard operating procedures and training documents.
• Assists with end user training.

Student Information Systems Analyst

Medical Billing and Coding

• Perform coding and related duties using established billing office policies in an accurate and timely manner.
• Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff.
• Coordinates professional service billings for selected clinical departments.
• Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.
• Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel to assure consistent and accurate change flow.
• Identify, report, and resolve coding and reimbursement issues.
• Develop and maintain all protocols related to their assigned areas.
• Maintain understanding all Teaching Physician and provider documentation policies.
• Actively participate in new provider orientations.

Coding Specialist II – Psychiatry

• Perform coding and related duties using established billing office policies in an accurate and timely manner.
• Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff.
• Coordinates professional service billings for selected clinical departments.
• Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements are applied.
• Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel.
• Identify, report, and resolve coding and reimbursement issues.

Coding Specialist II – Radiation Oncology

Manager

• Provide clinical, operational, and strategic leadership for Advanced Practice Providers across the transplant service
• Partner in a triad leadership model with transplant physician leadership and administrative leaders
• Maintain clinical practice within the Transplant Service Line contributing to the care of complex, high-acuity transplant patients
• Drive clinical quality, operational efficiency, and program growth initiatives

Advanced Practice Provider Manager – Transplant Surgery

Program Manager

• Direct the Statistical Operations functional area of the Center for International Blood and Marrow Transplant Research (CIBMTR).
• Develop, implement, and manage the Statistical Operations work portfolio for biostatisticians at CIBMTR MCW.
• Provide direction and guidance to the statistical team to facilitate collaboration with medical and scientific researchers in study/project design, development of research instruments, collection, management and analysis of data, interpretation of results, preparation of reports, and publication of research.
• Direct and supervise CIBMTR MCW statistical staff including recruitment, training, performance reviews, mentoring and corrective action.
• Develop and maintain a system to standardize/enhance onboarding, training and periodic assessment of Statistical Staff performance.
• Develop and facilitate professional development opportunities to support Statistical Staff engagement and retention.
• Drive strategic initiatives within the statistical area and supports the development of long-term growth plans and efficiency goals.
• Responsible for overseeing statistical operations requirements, communicating results to Senior Leadership, and developing strategies based on organizational reviews.
• Develop policies and standard operating procedures specific to statistical operations.
• Collaborate with other CIBMTR functional areas to establish standardized CIBMTR policies and procedures.
• Work closely with Scientific Directors and Statistical Staff in study design, study population, data file preparation, analyses and assisting in the preparation of scientific reports and manuscripts.