- Corewell Health (Stevensville, MI)
- …its doors in 2014. We are a 111-bed Skilled Nursing Facility that is Medicare and Medicaid Certified. The facility sits on Hansen Care Park's beautiful, wooded ... Wound Care. Pine Ridge is an overall 5 Star CMS rated facility and we work to ensure all...to the health of our organization. As a health system , we advocate for equity as we care for… more
- CVS Health (Lansing, MI)
- …Network Management supporting our Michigan market for our Commercial, Medicare , IFP, and Medicaid businesses. In this role, you will provide leadership, ... CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and… more
- Molina Healthcare (Ann Arbor, MI)
- …Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports ... be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. + Provides… more
- Munson Healthcare (Traverse City, MI)
- …Nationally-recognized care - our dialysis centers has been recognized by the Centers for Medicare and Medicaid Services ( CMS ) for providing some of the highest ... quality care in the nation + Close-knit communities - o ur patients are our neighbors and we are a big part of our communities + Work-life balance - get out on the water, in the woods, on the trails or around town after work + Commitment to growth and… more
- Fresenius Medical Center (Battle Creek, MI)
- …specific certification as defined by Center for Medicaid/ Medicare ( CMS )Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated ... machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . **RECORD KEEPING:** + Complete and document ongoing… more
- Molina Healthcare (MI)
- …contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability ... staff to determine; for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer… more
- Humana (Lansing, MI)
- …inventory monitoring and assignment of escalated inventory + Research on guidelines - CMS , AMA, etc. + Training new coders/auditors + Responsible for updating and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Trinity Health (Livonia, MI)
- …required modifiers. Utilizes coding guidelines established by: + The Centers for Medicare /Medicaid Services ( CMS ) ICD-CM Official Coding Guidelines for Coding ... for CPT codes and CPT Assistant + The American Health Information Management Association (AHIMA) Standards of Ethical Coding + Revenue Excellence/Health Ministry… more
- Trinity Health (Livonia, MI)
- …code(s) by utilizing coding guidelines established by: + The Centers for Medicare /Medicaid Services ( CMS ) ICD-CM Official Coding Guidelines for Coding and ... codes and Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes. Uses encoder software and coding abstracting … more
- Cognizant (Lansing, MI)
- …+ Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims. + Knowledge of Medicare /Medicaid payment and coverage ... and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper...and external SLAs. + Other duties as assigned by management . **Qualifications:** + A minimum of 2 years' claims… more