- Deloitte (Lansing, MI)
- …pricing studies + Implement competitive vendor search and selection initiatives + Review of health plan renewals including assisting in rate negotiation, and ... medical and pharmacy + Prepare financial projections and rate development + Review health plan performance, including reviewing policy year settlements and premium… more
- ITC Holdings (Novi, MI)
- …with consultants supporting our business. * Investigates and processes property damage claims . * Prepares maps and drawings to support the franchising process, as ... as a team, and maximize our individual strengths. Please take a moment to review our Diversity Statement (https://www.itc-holdings.com/docs/default-source/human-resources-support-docs/itc\_diversity\_statement.pdf?sfvrsn=507bcbf6\_2)… more
- Mondelez International (Farmington, MI)
- …(iDoc management, stock reconciliation), interfaces monitoring, track and trace, claims management, invoice management, compliance execution (HSE, quality, risk ... management, pallets management. **How you will contribute** You will: + Review and analyze stock inaccuracies and guarantee accurate stock alignment between… more
- Henry Ford Health System (Troy, MI)
- …payment arrangement, recognizing inaccurate information, partnering with legal to review bankruptcies, assisting with Coordination of Benefits, third party liability ... claims , etc. 5. Initiates and resolves account receivable errors with the hospital and professional billing or coding teams, which includes but is not limited to… more
- University of Michigan (Ann Arbor, MI)
- …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit practices for ... about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain compliance with… more
- Elevance Health (Dearborn, MI)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will ... make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical… more
- Banner Health (MI)
- …accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use of ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more
- Molina Healthcare (Ann Arbor, MI)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- Corewell Health (Grand Rapids, MI)
- …provider, etc. Investigates, collects and documents findings for management review . Investigation may include research, interviews, data analysis, and substantive ... desk or onsite medical record review . Responsible for preparing case file, final report and...records audits, data mining, perform compliance audits of medical claims , fee screens and other payment mechanism to ensure… more
- Evolent (Lansing, MI)
- …adjustment coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review . + Ensure compliance ... Stay for the culture. **What You'll Be Doing:** **Manager, Coding Support Specialist ** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager… more