- Guidehouse (Detroit, MI)
- …**Travel Required** **:** None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the direction of the Director ... services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject...hold edits, and claim denials. **This position is 100% remote ** .Daily duties for this position include: + Responsible… more
- Molina Healthcare (Detroit, MI)
- …tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources ... to validate overpayments made to providers. * Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. * Enters and updates recovery applications and… more
- Datavant (Lansing, MI)
- …to realize our bold vision for healthcare. As an **Inpatient Auditing Specialist ** you will be instrumental in addressing consulting and educational needs related ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...workspace! **Preferred: In need for a FT IP auditing specialist . Auditing specialist will be responsible for… more
- Elara Caring (Grand Rapids, MI)
- …at the Right Time, in the Right Place. **Job Description:** **Engage Clinical Care Specialist ** The Engage Clinical Care Specialist is part of the ElaraConnect ... programs that aims to improve patient outcomes on-service. The Engage Clinical Care Specialist supports the PCS Engage and PCS Branches, acting as a liaison for… more
- University of Michigan (Ann Arbor, MI)
- Provider Enrollment Specialist Apply Now **Job Summary** Coordinates employed and contracted billable provider's and facilities initial enrollment and ... with third party payers, out of state Medicaid and Medicare . Includes NPI management for facilities. Maintains database for...of Work** Positions that are eligible for hybrid **or** mobile/ remote work mode are at the discretion of the… more
- Highmark Health (Lansing, MI)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Henry Ford Health System (Rochester Hills, MI)
- …the growingHenry Ford Health Pharmacy Advantageteam as aFull-Time Pharmacy Benefits Specialist !Make a meaningful impact on patient care while enjoying aflexible ... hybrid schedule(In-person + Remote ). This role offers a$2,500 sign-on bonusandcomprehensive full-time benefits. You'll support patients and providers by helping… more
- Humana (Ann Arbor, MI)
- …caring community and help us put health first** The Community Engagement Specialist (Community Management Professional 2) builds visibility and credibility of the ... on language proficiency assessments. **Additional Information** + **Workstyle:** This is a remote position with travel. + **Workdays and Hours:** Monday - Friday;… more
- Integra Partners (Troy, MI)
- JOB OVERVIEW Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while maintaining ... cycle objectives + Stay informed on product information, changes in Medicare /State/Contract funding procedures, and updates in policies and procedures + Contribute… more
- Cardinal Health (Lansing, MI)
- ** Remote Hours: M-F 8:30-5:00 pm EST (or based on business needs)** **_What Contract and Billing contributes to Cardinal Health_** Contracts and Billing is ... + Submitting medical documentation/billing data to Commercial (MCO) and government ( Medicare /Medicaid) providers + Denials resolution for unpaid and rejected claims… more