- Cognizant (Lansing, MI)
- …Claims Adjudication. The ideal candidate will have a good understanding in Medicare, Medicaid Claims, Appeals and Grievances, and Commercial Claims. With a focus on ... accuracy and timeliness you will utilize your expertise in MS Excel to analyze data and support the claims process. This remote role offers a balanced work environment allowing you to contribute effectively while maintaining a healthy work-life balance.… more
- Marshfield Clinic (Iron Mountain, MI)
- …excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify ... his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action employer. All… more
- AmeriHealth Caritas (Detroit, MI)
- …to members, small groups, and external agencies. + Comprehensive knowledge of Medicaid requirements, plan policies, and procedures. + Must have a valid Michigan ... Driver's License, valid car insurance, and reliable transportation. + Traveling to and accessing members' homes and community locations within the assigned territory. + Must be able to travel to Wayne, Macomb, and Oakland counties. + Must be able to lift to 25… more
- Fresenius Medical Center (Dearborn Heights, MI)
- …assist devices for the heavier items. **EDUCATION** + Center for Medicaid /Medicare Services (CMS)-approved state and/or national certification or High School diploma ... or GED and must meet certification requirements within the required state or CMS timeline. + All appropriate state licensure education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS** + Previous patient care experience in a hospital setting… more
- Molina Healthcare (Sterling Heights, MI)
- …and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, ... educate/consult the health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting * Ability to… 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
- 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
- R1 RCM (Southfield, MI)
- …Additionally, you will need to gain and display a thorough understanding of Medicaid and other funding programs to provide patients with clear and concise ... information. Previous experience as a financial counselor with a background in medical terminology, understanding State and Federal assistance programs, or relevant healthcare experience is a plus. _Here's what you can expect working as a Financial Counseling… more
- Molina Healthcare (Detroit, MI)
- …legal processes (Commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid , Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP, ... or other similar claims processing systems. + Demonstrated ability to use MS Excel/Access platforms working with large quantities of data to answer questions or identify trends and patterns, and the ability to present those findings. **Preferred License,… more
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