- University of Michigan (Ann Arbor, MI)
- …with providers + Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials ; input into appeals ; share findings with providers + Review all ... cases with readmission within 30 days; report findings in Care Management software such as Allscript + Identify opportunities for cost reduction and participate in appropriate utilization management venues + Conducts referrals and consultation with Physician… more
- R1 RCM (Southfield, MI)
- …and workflow orchestration. As our **Operations Support 1** , you will help our Denials /AR team by submitting the required documents for prepared appeals . Every ... packages to be submitted to various payers + Submit appeals to various payers in accordance with specific facility...in accordance with specific facility protocols + Navigate Quantum Appeals , R1 software suite, and combined use of other… more
- Intermountain Health (Lansing, MI)
- …all pertinent patient related insurance eligibility, benefits, authorization; follow-up on appeals and denials when requested + Contacts patient/provider when ... insurance eligibility, securing prior authorization and managing authorization related denials to ensure patient financial health. **Essential Functions** +… more
- Molina Healthcare (Warren, MI)
- …by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Henry Ford Health System (St. Clair Shores, MI)
- …and hospital. . Provides appropriate documentation that meets insurance company requirements; works appeals to all denials in a timely manner. . Participates in ... inpatient and outpatient consultation for specialty which may include on call schedules. . Completion of an accredited OBGYN residency program. . BE/BC specialty. #pr Additional Information + Organization: Henry Ford Ascension Medical Group MI + Department: St… more
- Intermountain Health (Lansing, MI)
- …levels, providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides ... in-depth coding review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and… more
- Trinity Health (Livonia, MI)
- …support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials . 5. Works Inpatient claim edits and may code consecutive/combined accounts to ... (PBS) teams, when needed, to help resolve billing, claims, denial, and appeals issues affecting reimbursement. 10. Maintains CEUs as appropriate for coding… more