- Molina Healthcare (Grand Rapids, MI)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Warren, MI)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving... appeals and denials . + Strong verbal and written communication skills To… more
- Corewell Health (Grand Rapids, MI)
- …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... faxing and uploading to EPIC. + Assists with training new team members utilizing standard work. + Ability to perform the role of Patient Services Representative, Associate when necessary. + Actively participates in safety initiatives and risk mitigating… more
- Corewell Health (Grand Rapids, MI)
- …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... faxing and uploading to EPIC. + Assists with training new team members utilizing standard work. + Ability to perform the role of Patient Services Representative, Associate when necessary. + Actively participates in safety initiatives and risk mitigating… more
- Corewell Health (Watervliet, MI)
- …for communication with appropriate health insurance companies regarding authorizations and denials . Executes standard work regarding Medicaid appeals / denials ... for obtaining necessary prior authorizations, submitting documentation to appeal denials , and educating clinicians regarding proper documentation for all Inpatient… more
- Adecco US, Inc. (Detroit, MI)
- …investigation and prior authorization * Provide patient access support related to claims, denials , and appeals * Facilitate training on payer landscape and hub ... support services * Maintain CRM data and reporting for client visibility and compliance **Candidates for Field Reimbursement Manager must meet the following requirements to be considered:** * 3+ years of healthcare reimbursement experience (Medicare &… more
- Trinity Health (Livonia, MI)
- …Business Services (PBS) teams, when needed, to help resolve billing, claims, denials and appeals issues affecting reimbursement. Exhibits awareness of health ... record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate. Utilizes EMR communication tools to track missing documentation that requires follow-up to facilitate coding in a timely fashion.… more
- Trinity Health (Livonia, MI)
- …Business Services (PBS) teams, when needed, to help resolve billing, claims, denials and appeals issues affecting reimbursement. Exhibits awareness of health ... record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate. Utilizes EMR communication tools to track missing documentation or Outpatient queries that require follow-up to facilitate coding… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Denials & AR Analyst I, you will help R1 clients by analyzing ... craft appeal letters to resolve any insurance company medical denials . To thrive in this role, you must excel...to learn the status of previously resubmitted claims, written appeals , or updates on incoming claims payments. + Utilizing… more
- Cardinal Health (Lansing, MI)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more