- Integra Partners (Troy, MI)
- JOB OVERVIEW Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while ... documentation and account records, as well as timely issue resolution . In this role, you will ensure work is...HIPAA compliance. If you have previous medical billing or claims experience, this role may be of interest as… more
- Molina Healthcare (Detroit, MI)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution ... Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members,… more
- Molina Healthcare (Ann Arbor, MI)
- …for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with ... Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from… 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 ... audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of… more
- Henry Ford Health System (Troy, MI)
- …completeness of patient financial, insurance and demographic information to ensure compliant claims are sent to payers. The Sr. Specialist works independently ... The CBO Insurance Sr. Specialist is responsible for effectively and efficiently resolving...for his/her functional area, coaching team members on account resolution workflows, and assisting the supervisor with team management.… more
- Wacker Chemical (Ann Arbor, MI)
- Customs Compliance Specialist II Job Location (Short): Ann Arbor, MI, USA, 48108 | Charleston, TN, USA, 37310 Posting Start Date: 9/17/25 Do you want to take ... Arbor, we are looking for you as a(n)Customs Compliance Specialist II. This role will provide direction and support...This role will support auditing and investigations regarding customs claims and inquiries. Candidates should have a high degree… more
- Sedgwick (Lansing, MI)
- …Fortune Best Workplaces in Financial Services & Insurance Provider Network Specialist **PRIMARY PURPOSE** **:** To ensure clients and Managed Care Organization's ... MCO provider additions and removals, MCO network issues; makes recommendations for resolution . + Contacts providers to verify new workers' compensation patients are… more
- McLaren Health Care (Flint, MI)
- …of the laboratory department and revenue cycle department leadership, the Lab Billing Specialist works on resolution efforts for coding and billing problems that ... prevent submission of insurance claims as well as technical denials for claims not paid. Works closely with Coding and Billing departments in this effort.… more
- Molina Healthcare (Sterling Heights, MI)
- …and timely validation and maintenance of critical provider information on all claims and provider databases (using SQL, Excel, and QNXT). Staff ensure adherence ... areas of responsibility (eg, Provider Services/Provider Inquiry Research & Resolution , Provider Contracting/Provider Relationship Management). + Provides timely, accurate… more
- Ford Motor Company (Allen Park, MI)
- …maneuvers or during a failed battery state. **3. Quality, Reliability & Problem Resolution :** + Lead the investigation, root cause analysis, and resolution of ... testing), and formal sign-off processes. + **Quality, Reliability & Problem Resolution :** Extensive experience in leading root cause analysis, problem-solving, and … more