- Humana (Lansing, MI)
- …resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services ... **Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that… more
- TEKsystems (Troy, MI)
- Please see details for the opening: Job Title: Customer Claims Specialist Category: Mortgage, Insurance Pay Range: 17$/hour Location: Office - 700 Tower Drive, ... 1-2 years of call center experience, preferably in escalations, claims , or insurance + Strong resilience and... or similar case types + Prior work with Medicaid/ Medicare callers or similar customer profiles Job Responsibilities: +… more
- Molina Healthcare (Ann Arbor, MI)
- …to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. Also provides product and service information, identifies ... for a wide variety of inquiries and assistance involving their benefits, claims , premiums, and other areas including very complex issues. Conducts initial research… more
- Trinity Health (Ann Arbor, MI)
- …customer service. Performs outpatient & / or inpatient registration & insurance verification functions; collects patient financial liability payments & ensures that ... patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users,… more
- Trinity Health (Ann Arbor, MI)
- …customer service. Performs outpatient & / or inpatient registration & insurance verification functions; collects patient financial liability payments & ensures that ... patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to hospital users,… more
- Fresenius Medical Center (Wyoming, MI)
- …coordinate insurance options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal ... and annual indigent waivers. + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include… more
- Hart Medical Equipment (Grand Blanc, MI)
- …Ensures quality assurance for processed orders respecting Hart policies and insurance guidelines. Ensures the Certificate of Medical Necessity is completed to ... release claims . ESSENTIAL DUTIES AND RESPONSIBILITIES: Reasonable accommodations may be...essential functions. + Reviews documentation to confirm qualifications for insurance guidelines have been met. + Creates Certificate of… more
- Highmark Health (Lansing, MI)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more