- Integra Partners (Troy, MI)
- JOB OVERVIEW Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while ... documentation and account records, as well as timely issue resolution . In this role, you will ensure work is...and procedures, including HIPAA compliance. If you have previous medical billing or claims experience, this role… more
- Sedgwick (Grand Rapids, MI)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , Veterinary Claims | Professional Liability | Remote ... **PRIMARY PURPOSE** **:** To analyze complex or technically difficult veterinary claims ; to provide resolution of highly complex nature and/or severe injury … more
- Travelers Insurance Company (Lansing, MI)
- …of claim and litigation strategy. + Recognize and implement alternate means of resolution . + Manages litigated claims . Develop litigation plan with staff or ... reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality… more
- Trinity Health (Livonia, MI)
- …8:30 am-5pm No Weekends w/Holiday Rotations** **Position Purpose:** The Authorization Specialist is responsible and accountable for the processing of all THAH ... and THAH Collection analysts in the tracking of authorizations and resolution of problematic billing issues. Monitors pending authorizations report and collaborates… more
- Molina Healthcare (MI)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution ... Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members,… more
- Cardinal Health (Lansing, MI)
- …data to Commercial (MCO) and government (Medicare/Medicaid) providers + Denials resolution for unpaid and rejected claims + Preparing, reviewing ... right things done. **_Responsibilities_** + Working unpaid or denied claims to ensure timely filing guidelines are meet. +...work experience preferred + 1+ years experience as a Medical Biller or Denials Specialist preferred +… more
- Guidehouse (Detroit, MI)
- …billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims . + Proficiency in determining accurate ... for this position include: + Responsible for the daily resolution of assigned claims with applicable Revenue...Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as… more
- Sedgwick (Lansing, MI)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance ADA Accommodation Specialist **PRIMARY PURPOSE** : To enhance the ADA process for claimants ... requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation requests; and to approve and/or negotiate… more
- Henry Ford Health System (Detroit, MI)
- …patient access hub workflows related to medication access, prior authorizations, and claims resolution . Collaborate with pharmacists and care teams to implement ... patients' medication access by managing infusion and injection benefit claims , ensuring financial viability, and addressing affordability concerns throughout the… more
- Henry Ford Health System (Jackson, MI)
- …obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits ... Network. * Serves as the point of contact for Network practices to address claims issues with Network payors by troubleshooting on behalf of the practice and working… more
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