- 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
- Molina Healthcare (Warren, MI)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation… more
- Trinity Health (Livonia, MI)
- …charge errors accordingly. Epic experience desired. Experience and knowledge of working on appeals for insurance denials and identifying root cause. Knowledge of ... Hospital and/or Physician group practice revenue cycle front-end functions such as patient registration and provider payment enrollment and back-end functions that may impact charge related errors. Ability to organize and to prioritize work in a diverse,… 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
- Cardinal Health (Lansing, MI)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… 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
- 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 ... 8:00 AM - 5:00 PM (field-based) * Weekly paycheck * Dedicated Onboarding Specialist & Recruiter * Access to Adecco's Aspire Academy with thousands of free… 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 ... Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required. Two (2) years of current acute care… more