- Molina Healthcare (Warren, MI)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... determine appeal and grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Warren, MI)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation… more
- Trinity Health (Livonia, MI)
- …charge errors accordingly. Epic experience desired. Experience and knowledge of working on appeals for insurance denials and identifying root cause. Knowledge of ... charges/coding are in alignment within AMA and Medicare coding guidelines. Ensures medical documentation and coding compliance with Federal, State and Private payer… more
- Intermountain Health (Lansing, MI)
- …levels, providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides ... and billing requirements. + Demonstrates strong knowledge and understanding of medical terminology, medical acronyms, pharmacology, anatomy and physiology and… more
- Cardinal Health (Lansing, MI)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… more
- Adecco US, Inc. (Detroit, MI)
- …investigation and prior authorization * Provide patient access support related to claims, denials , and appeals * Facilitate training on payer landscape and hub ... 8:00 AM - 5:00 PM (field-based) * Weekly paycheck * Dedicated Onboarding Specialist & Recruiter * Access to Adecco's Aspire Academy with thousands of free… more
- Trinity Health (Livonia, MI)
- …Business Services (PBS) teams, when needed, to help resolve billing, claims, denials and appeals issues affecting reimbursement. Exhibits awareness of health ... and Reporting + The American Hospital Association (AHA) Coding Clinic + The American Medical Association (AMA) for CPT codes and CPT Assistant + The American Health… more
- Trinity Health (Livonia, MI)
- …support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials . 5. Works Inpatient claim edits and may code consecutive/combined accounts to ... (PBS) teams, when needed, to help resolve billing, claims, denial, and appeals issues affecting reimbursement. 10. Maintains CEUs as appropriate for coding… more