- Area Agency On Aging 1-b (Southfield, MI)
- …years of experience in an administrative clinical setting, including 1-2 years Medicaid managed care appeals process & Health/Human Services. + Proven ability to ... The Appeals and Grievance Specialist is responsible for managing and resolving appeals...thinking, and problem-solving skills. + Possesses experience in Medicaid managed care appeals process, HIPAA privacy rules,… more
- Prime Healthcare (Garden City, MI)
- …, Account Resolution is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications EDUCATION, EXPERIENCE, TRAINING 1.… more
- Prime Healthcare (Garden City, MI)
- …Specialist , Billing is the lead responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. #LI-BM2 Qualifications 1. Minimum of four years… more
- Molina Healthcare (Ann Arbor, MI)
- …diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and ... Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.… more
- Molina Healthcare (Warren, MI)
- …High School Diploma or equivalency **REQUIRED EXPERIENCE:** + Min. 2 years operational managed care experience (call center, appeals or claims environment). + ... Responsible for meeting production standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting… more
- Molina Healthcare (Ann Arbor, MI)
- …ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates with the management team and other ... field including, but not limited to, provider's office, managed care , or other health care...multispecialty provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
- Highmark Health (Lansing, MI)
- …+ High school diploma /GED + 3 years of experience required in health care / managed care + 3 years of experience in credentialing/re-credentialing of ... Establish and implement monitoring processes to evaluate performance against contract standards, requirements and performance expectations. + Identify opportunities… more