- CenterWell (Lansing, MI)
- …diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore ... Coding Operations works on problems of diverse scope and complexity ranging from moderate to substantial. The **Program Management Lead, Offshore Coding Operations** optimizes the effectiveness of the offshore coding (post-visit) team. The lead analyzes the… more
- McLaren Health Care (Flint, MI)
- …health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health ... insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ . **Position Summary:** Responsible for the education and servicing of assigned provider groups regarding all aspects of the Plan and its subsidiaries. Responsible for assisting in… more
- Humana (Lansing, MI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- Humana (Lansing, MI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- CVS Health (Lansing, MI)
- …Services Senior Coordinator will have responsibility to support loading all Medicaid new and revised participating provider data transactions within Aetna/CVS source ... systems. **What you will do** + Daily activities include writing simple SQL queries and pull reports on both an ad hoc and production basis for analysis of data present in QNXT/Source systems + Proactively define, identify and recommend process enhancements or… more
- Humana (Lansing, MI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- Fresenius Medical Center (Ann Arbor, MI)
- …certification as defined by Center for Medicaid /Medicare Services (CMS)Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment ... to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + At least two years previous patient care experience in a hospital setting or a related facility preferred. + Continued employment is dependent on… more
- Humana (Lansing, MI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- Humana (Lansing, MI)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- Actalent (Grand Rapids, MI)
- …of appeals. Responsibilities + Handle denied Prior Authorizations for Medicare and Medicaid patients. + Review provided information and reach out for additional ... details if needed. + Send cases to Pharmacists for final determination. + Make approximately 60 outbound calls per shift to Medicare/elderly members. + Manage calls with frustrated members whose medication has been denied. Essential Skills + Pharmacy… more
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