- Datavant (Lansing, MI)
- …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of ... Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with...as it relates to job function as delegated by management Ideal candidate should be a Licensed Practical Nurse… more
- Henry Ford Health System (Detroit, MI)
- …revenue cycle principles, charge capture processes, and compliance best practices. + Denials Management & Process Optimization: Partner with Revenue Integrity ... Services Center - Detroit Schedule: Full Time The Pharmacy Specialist is a pharmacist who, by virtue of knowledge...Health's Clinical Delivery System as part of our Medication Management program. + Financial Stewardship & Compliance: Develop and… more
- McLaren Health Care (Mount Pleasant, MI)
- …and Responsibilities as Assigned:** 1. Supports activities consistent with Integrated Care Management Denials across all MHC subsidiaries. 2. Accountable for ... education sessions to maintain competency and knowledge of regulations in denials , utilization management , care management , clinical documentation,… more
- Henry Ford Health System (Troy, MI)
- …involving all appropriate personnel. Prepares reports and recommendations for management and coordinates implementation. The Revenue Integrity Specialist ... SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with Revenue Cycle… more
- Henry Ford Health System (Troy, MI)
- …and assisting the supervisor with escalated issues. The CBO Coding Senior Specialist confirms the accuracy and completeness of coding to ensure compliant claims ... are sent to payers. The CBO Coding Senior Specialist works independently to resolve complex diagnostic accounts. The...sending out clean quality claims and working and preventing denials . EDUCATION/EXPERIENCE REQUIRED: + High school diploma or GED… more
- Henry Ford Health System (Detroit, MI)
- …ensure compliant claims to Third party payers. Resolves problem accounts from payer denials and follows up on any claims that require a payer response. Responsible ... knowledge in all claims processing, including claims submissions , denials , and follow up procedures used to train other...team members + Independently interact with various levels of management , physicians , clinic personnel to identify process… more
- Molina Healthcare (Grand Rapids, MI)
- …and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals ... and denials . * Customer service experience. * Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet… more
- Molina Healthcare (MI)
- …and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals ... and denials . * Customer service experience. * Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet… more
- Carrington (Lansing, MI)
- …and work remote from home!** The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation on all liquidated loans. Identify ... informed of all trends and problems including, but not limited to, claim denials /curtailments and claim payment offsets. + Moderate working knowledge of all Default… more
- Carrington (Lansing, MI)
- …team and work from home!** The Loss Mitigation Underwriting Quality Control Specialist primary responsibilities consist of reviewing the accuracy of work performed ... by the Loss Mitigation Underwriters including the review of approvals, denials , income calculations and final conversion calculations. Incumbent will review… more