- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- …access, billing, and coding in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare ... **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert... Manager (FRM) serves as the subject-matter expert on reimbursement , access, and coverage issues for our products, primarily… more
- Corewell Health (Grand Rapids, MI)
- …with CMS & State of Michigan regulations. Maintains up-to-date knowledge of Medicare / Medicaid rules and regulations. + Facilitate the timely and accurate ... reports and assist in ad-hoc analysis. Knowledge of facility and physician reimbursement methods will be combined with data analysis and decision-making abilities to… more
- Cardinal Health (Lansing, MI)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, ... preferred + Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and… more
- Molina Healthcare (Detroit, MI)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... CMS Guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid , Medicare , CHIP and Marketplace, applicable State regulatory… more
- Molina Healthcare (Sterling Heights, MI)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. +...experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning… more
- Molina Healthcare (Sterling Heights, MI)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... a Managed Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and… more
- Molina Healthcare (Grand Rapids, MI)
- …relevant education and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept ... ability to synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business. + PMP,… more
- University of Michigan (Ann Arbor, MI)
- …level of care, administrative and outpatient denials. They manage and respond to Medicare , Medicare Advantage, Varis, Medicaid and other various commercial ... Utilize knowledge of CMS regulations, OPPS coding for surgical procedures and the Medicare inpatient only list to ensure accurate reimbursement . + Review… more
- Gentiva (Portage, MI)
- …and practice, including industry standards, regulations, and best practices (ie, Medicare , Medicaid , JCAHO, ACHC), company policies/procedures, and understanding ... families. + Thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare , Medicaid , JCAHO, ACHC, and human resource) management principles… more
- Trinity Health (Ann Arbor, MI)
- …health insurance guidelines, programs and plans; patient and co-pay assistance programs; Medicare and Medicaid health plans: COBRA guidelines, and the ability ... representatives to provide financial assistance, and facilitates processing of Medicaid and other financial assistance applications. Provides patient and health… more