- Cardinal Health (Lansing, MI)
- …to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage the daily ... of escalation for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends… more
- Oracle (Lansing, MI)
- …delivery through powerful, AI-driven workflow innovation. Our Autonomous Reimbursement, Payer , and Interoperability teams are developing advanced solutions to ... technical program management efforts across mission-critical projects in RevenueCycle, Payer , and Interoperability domains. + Design, implement, and continuously… more
- Banner Health (MI)
- …Representative (Ambulatory Denials)** is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. ... resume;** + **Minimum of 1 year experience writing appeal letters for payer /payor denials;** + **Intermediate to Advanced skill level in Microsoft Excel.** This… more
- R1 RCM (Detroit, MI)
- …years of experience in healthcare operations (ie revenue cycle management, provider, payer , vendor). + Experience with Excel, Power BI or similar analytical tools. ... of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare… more
- Munson Healthcare (Traverse City, MI)
- …all times. + Maintains working knowledge/experience in utilization management, managed care, and payer issues that may impact the course of care. + Timely response ... to focus on patient/family goals, interdisciplinary team recommendations, available payer benefits and private financial considerations which may impact placement.… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- …in-market products. Partners with Insights & Analytics team to assess impact of payer access controls and price on in-market and pipeline products. Works closely ... + A minimum of 10+ years of pharmaceutical industry, Market Access, or payer experience + Thorough understanding and knowledge of US healthcare economics and the… more
- Merck (Lansing, MI)
- …targeting and business analysis. + Articulates the complexities of the HIV payer environment, recognizing the role each stakeholder plays in the ability to ... and build partnerships with key stakeholders/departments. + Experience with complex payer environments, recognizing the role each stakeholder plays in the ability… more
- Trinity Health (Spring Lake, MI)
- …for missing prior authorization or referral within the EMR system. + Confirms payer is in-network with specialist. If not, contacts patient to discuss and make ... alternate arrangements as necessary per payer guidelines in communication with the care team. + Maintains and updates reference materials as they pertain to… more
- Trinity Health (Livonia, MI)
- …fraud prevention. Reviews bulletins to maintain an understanding of regulatory & payer changes to assure correct charging & billing. Coordinates pricing increases as ... charging processes & audits & clinical billing. Working knowledge of third-party payer rules & requirements, computer operations & electronic interfaces related to… more
- Hart Medical Equipment (Southfield, MI)
- …individual and team training modules as it relates to products and changes to payer policies. + Accountable to manage to budget and adjust operations to meet ... industry and multiple facets/departments of operations which includes equipment, payer sources, regulatory aspects, and front-line/customer engagement experience. Language… more
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