- Sedgwick (Lansing, MI)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Grand Rapids, 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
- CVS Health (Lansing, MI)
- …improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in providing our ... all with heart, each and every day. **Job Summary** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the… more
- Henry Ford Health System (Troy, MI)
- …completeness of patient financial, insurance and demographic information to ensure compliant claims are sent to payers. The Sr. Specialist works independently ... The CBO Insurance Sr. Specialist is responsible for effectively and efficiently resolving...Ford is one of the nation's most respected academic medical centers and is leading the Future of Health:… more
- Molina Healthcare (Detroit, MI)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to… more
- CDM Smith (Lansing, MI)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
- Henry Ford Health System (Detroit, MI)
- …of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials ... and follows up on any claims that require a payer response. Responsible for the...a healthcare revenue cycle position, preferred. + Knowledge of Medical terminology, preferred. + Knowledge of CPT/HCPCS revenue codes,… more
- CVS Health (Lansing, MI)
- …_Cost Avoidance Research Effort_ ) team. The **Meritain Pharmacy Solutions CARE Specialist ** will engage with patients, helping them to navigate the complexities of ... members and self-funded clients. + Monitors performance of high dollar specialty claims . + Research and outreach on appropriate interchanges of medications from 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
- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST ** **Location:** Trinity Health PACE Corp Michigan **Status:** Full time ... ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from … more