- Zurich NA (Lansing, MI)
- Sr. Claims Specialist - Complex Construction 126105 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our ... team. This role is essential in managing complex, high-exposure construction, and litigation claims , while supporting the New York Labor team to ensure claims … more
- CVS Health (Lansing, MI)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... and interpersonal skills. + Previous experience with DG system claims processing. **Education** + Associate 's degree or...with DG system claims processing. **Education** + Associate 's degree or equivalent experience (high school diploma or… more
- Molina Healthcare (Sterling Heights, MI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to… more
- Molina Healthcare (Warren, MI)
- …to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists with interdepartmental issues ... **I** **E** **N** **C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service experience in a managed… more
- Molina Healthcare (Ann Arbor, MI)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
- Trinity Health (Ann Arbor, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Trinity Health (Howell, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- University of Michigan (Ann Arbor, MI)
- Outpatient Authorization Specialist Apply Now **Job Summary** The Authorization Specialist is responsible for facilitating and successfully procuring outpatient ... insurance authorizations. The Authorization Specialist will be accountable to one or more designated...thoroughly. + Obtain retro authorizations on billed and rejected claims and denied procedure codes for facility and professional… more
- Morley (Saginaw, MI)
- …training on site)_ Join Morley's legal team as a Contracts and Legal Specialist , where you'll play a critical role in supporting our legal operations, contracts ... **_Questions Before You Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 8 am - 5 pm Eastern… more
- Walgreens (Grandville, MI)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more