- Integra Partners (Troy, MI)
- …InterQual, CMS, health plan policies). + Review and process clinical and administrative appeals ; coordinate with Medical Director when required. + Generate ... Medicare and Medicaid requirements. + Familiarity with DMEPOS authorization and appeals processes. + Knowledge of medical necessity criteria (InterQual, CMS,… more
- Corewell Health (Watervliet, MI)
- …Responsible for ensuring optimal reimbursement through analytical review of medical records and collaboration with interdisciplinary teams, including billing, ... coding, and medical team members. Also responsible for obtaining necessary prior...tool including transmission of records to the Centers for Medicare and Medicaid Services (CMS) and other insurances as… more