- LG Energy Solution (Holland, MI)
- …such items as physicians' reports on employee health, workers' compensation insurance claims , medical restrictions on employee work, and the policies and procedures ... investigate, and manage work-related injuries and illnesses, including Workers' Compensation claims + Manage return to work approval process + Provide support… more
- Molina Healthcare (Warren, MI)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing ... GED **Required Experience/Knowledge Skills & Abilities:** Certified Provider Credentialing Specialist (CPCS) or participation in a CPCS progression program.… 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
- Cognizant (Lansing, MI)
- Cognizant is seeking an IBM i (AS400) Infrastructure Specialist to support the IBM i infrastructure for RxClaims. This position will perform level 1 monitoring of ... health monitoring of: Claim adjudication jobs, ASP alerts, CPU alerts, Claims queue monitoring, Storage monitoring, Connect Direct subsystem. + Contact different… more
- LG Energy Solution (Holland, MI)
- Title: Specialist I, Information Security Reports to: Security Manager Location: Holland, MI LG Energy Solution Michigan Inc. (LGESMI) develops and manufactures ... incidents, including acts of violence; investigate incidents and prepare reports for insurance claims and legal proceedings + Work with local law enforcement and on… more
- Carrington (Lansing, MI)
- …Bankruptcy Ledger Experience Required to be Considered!** The Bankruptcy Ledger Specialist will be responsible for completing and monitoring ledgers through the ... high degree of accuracy, for all Bankruptcy processes including Acquisitions, Proof of Claims , Notice of Final Cures, Motions for Relief, Agreed Orders, Notices of… more
- Prime Therapeutics (Lansing, MI)
- …drives every decision we make. **Job Posting Title** Business Intelligence Specialist - Sacramento, California market **Job Description** Delivers against business ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given… more
- Trinity Health (Livonia, MI)
- …certification required, eg, Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technologist (RHIT), or Registered ... Must have extensive knowledge in the guidance outlined in the Medicare Claims Processing Manual, Medicare Program Integrity Manual, & National Correct Coding… more
- KMG Prestige (Ann Arbor, MI)
- …challenges, and thrives within a deadline driven schedule. The Area Certification Specialist is responsible for supporting Section 8 and Tax Credit communities in ... response support, EIV oversight, MOR pre- inspections and prep, Special claims processing, internal file and compliance auditing, onsite compliance training and… more
- Gilead Sciences, Inc. (Detroit, MI)
- …the lives of patients with life-threatening illnesses worldwide. As an Therapeutic Specialist - HBV you are responsible for representing Gilead's products and ... and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office… more