- University of Michigan (Ann Arbor, MI)
- …appropriate, by applying expert knowledge, expertise, and experience. Acting as a specialist in the complex Michigan Medicine credentialing process has the authority ... world and has been the site of many groundbreaking medical and technological advancements since the opening of the...and safeguard Michigan Medicine against loss of accreditation, malpractice claims , and claims of negligent credentialing. +… more
- Molina Healthcare (MI)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
- Morley (Lansing, MI)
- …work with car, truck or SUV parts as a car enthusiast, or as an auto retail specialist at a parts store or dealership? This could be a great career move for you - ... **_Questions Before You Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 8 am - 5 pm Eastern… more
- Army National Guard Units (Lansing, MI)
- …TAG. Program and case management functions are evaluated by the SAPR Program Specialist at National Guard Bureau. This position has direct and unimpeded access to ... support a temporary surge or vacancy, in coordination with the SAPR Program Specialist . 1. Program Administration 75% Execute Department of Defense and Service level… more
- Trinity Health (Spring Lake, MI)
- …- Friday. No weekends or Holidays. + Comprehensive benefit packages available including medical , dental, vision, paid time off and 403B + Mercy Health Physician ... in timely fashion with proper documentation. + Works denied claims for missing prior authorization or referral within the...the EMR system. + Confirms payer is in-network with specialist . If not, contacts patient to discuss and make… more
- Centene Corporation (Lansing, MI)
- …(NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies ... community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance… more
- Elevance Health (Dearborn, MI)
- …regular basis to determine whether treatment meets Carelon Behavioral Health criteria for medical necessity. Refers cases to an MD or Clinical Management staff if ... unable to determine that medical necessity criteria have been met. Establish and deliver...+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more
- Medtronic (MI)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more
- Ford Motor Company (Dearborn, MI)
- …+ Define vendor strategy and lead the selection of strategic partners ( medical /dental/vision carriers, PBMs, and carve-out specialty vendors) that align with Ford's ... team to deliver consistently excellent health care plan administration, including medical , pharmacy, dental, and vision programs across union and non-union… more
- Morley (Saginaw, MI)
- …**_Questions Before You Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 8 am - 5 pm Eastern ... provides - your total compensation package. **_Health & Wellness Benefits_** + Medical and prescription coverage, including free annual physicals + Dental and vision… more