- Lincoln Financial (Lansing, MI)
- …to staff our ever-growing claims organization. As a Short Term Disability Claims Specialist , you will be responsible for conducting initial and ongoing ... home, then please read on! Click the following link Claims Specialist Job Preview (https://marketingmedia.lfg.com/lfg/DOCS/lfd/emailMarketing/Video/6369162297112.html) to see… more
- Cognizant (Lansing, MI)
- …of claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able… 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
- Sedgwick (Detroit, MI)
- …for absence from work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes ... Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical evaluations, consult...medical review of all claims to ensure information substantiates disability. + Provides clear… more
- University of Michigan (Ann Arbor, MI)
- Pre-Certification Specialist Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the first page of ... scheduled short stay and inpatient admissions to the hospital. The precertification review process includes the application of diagnosis and procedure codes and the… more
- Prime Therapeutics (Lansing, MI)
- …results with limited supervision. + Demonstrated strategic and analytical abilities to review and evaluate information such as claims data, suspicious patterns ... drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… 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
- CVS Health (Lansing, MI)
- …And we do it all with heart, each and every day. **Position Summary** Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims ; ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Molina Healthcare (Warren, MI)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting the member/provider through written… 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