- Trinity Health (Livonia, MI)
- …charging processes & audits, & clinical billing Working knowledge of third-party payer rules & requirements, computer operations & electronic interfaces related to ... charge documentation, capture & billing is required. Knowledge of charge capture, reconciliation, error management operations & overall revenue cycle operations required. **Additional Qualifications (nice to have)** Registered Nurse, strongly preferred… more
- Evolent (Lansing, MI)
- …+ 4+ years of experience in healthcare analytics, preferably with a payer , provider, or healthcare consulting organization. + Strong proficiency with SQL, SAS, ... and Microsoft Excel + Strong communication skills with the ability to bridge technical and business perspectives. + Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data **Finishing Touches… more
- Sevita (Detroit, MI)
- …other stakeholders; identify opportunities by following industry trends, responding to payer needs, and requests for proposal. + Identify potential candidates for ... tuck-in or acquisition; assist with diligence and integration planning; assume management of acquired entities. + Direct strategy across multiple states to increase census, maintain occupancy, improve daily attendance, and maximize utilization. + Financial… more
- Datavant (Lansing, MI)
- …to ensure appropriate reimbursement and clinical severity for DRG-based payer patients. + Demonstrate understanding of complications, co-morbidities, severity of ... illness, risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG. + Improve coding specificity by educating physicians and caregivers on the importance of clear documentation throughout a patient's stay. + Follow AHA guidelines and… more
- Tenet Healthcare (Detroit, MI)
- …to ensure accurate bill production. Ensures compliance with third party payer requirements. Registers and schedules patients for health services ensuring ... appropriateness of setting for services provided Explains appropriate forms to patient and family and ensures that necessary consent, regulatory forms, and MSP questionnaire (if applicable) are completed correctly and that patient signatures are obtained.… more
- McLaren Health Care (Grand Blanc, MI)
- …Appeal letters will include compelling factual argument and submit to insurance payer requesting timely payment for services. 3. Assists in running reports and ... utilizes tools (ie, MHC Data Warehouse, level of care (LOC), Optum, Veracity, CBO MHC Denials Dashboard) for reporting trends and identifies opportunities for potential denials management impact on medical necessity and DRG denials 4. Conducts patient medical… more
- Centene Corporation (Lansing, MI)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs + Provides feedback to leadership on opportunities to improve and enhance care and quality… more
- R1 RCM (Warren, MI)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- Cardinal Health (Lansing, MI)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Evolent (Lansing, MI)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... + Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs + Exceptionally strong analytical abilities, with track record of identifying and communicating insights from… more