- CenterWell (Lansing, MI)
- …help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care ... variable factors. The Medical Director relies on medical background and reviews health claims . The...An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Centene Corporation (Lansing, MI)
- …support for business operations in all or some of the following areas: claims , provider data, member data, clinical data, HEDIS, pharmacy, external reporting + ... economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.… more
- Humana (Lansing, MI)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background,...but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes… more
- Centene Corporation (Lansing, MI)
- …within a managed care environment related to HEDIS record review, quality improvement, medical coding or transferable skill sets that demonstrates the ability to ... performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Assists in delivering provider specific...education to providers and provider staff OR 2 years medical coding or other transferable experience and… more
- CVS Health (Lansing, MI)
- …skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical coding , and regulatory frameworks. + Excellent ... and coding practices, verifying document authenticity, and identifying false claims or improper billing. + **Data-Driven Analysis** : Utilizes advanced data… more
- Prime Therapeutics (Lansing, MI)
- …lead analyst in producing reports, scorecards, or other data using Pharmacy and/or Medical claims data to support projects and initiatives throughout the ... relevant Healthcare experience including: analyzing and using healthcare claims data, clinical research study design,...study design, and/or epidemiology + Previous experience with SQL coding + Must be eligible to work in the… more
- R1 RCM (Detroit, MI)
- …collaboration. **It's** **a plus if you bring:** + Experience with healthcare operations/RCM (FHIR/HL7, claims , denials) and/orregulated industries with ... R1 is thrilled to introduce R37 committed to transforming healthcare financial performance, so providers can focus on delivering exceptional care. R37 is pioneering… more
- Henry Ford Health System (Jackson, MI)
- …obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits ... Network. * Serves as the point of contact for Network practices to address claims issues with Network payors by troubleshooting on behalf of the practice and working… more
- Danaher Corporation (Detroit, MI)
- …/ customer facing role responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. This role ... this role, you will have the opportunity to: + Provide education to healthcare providers, lab professionals, office staff and financial decision makers on Cepheid… more
- US Physical Therapy (Big Rapids, MI)
- … billing and collections + Knowledge of medical billing and coding , insurance regulations, and healthcare reimbursement policies + Strong attention to ... to obtain prior authorizations and verify coverage + Follow up on unpaid claims and denials + Maintain accurate and up-to-date patient account information + Provide… more