- Highmark Health (Lansing, MI)
- …coordination of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + ... **Minimum** + High school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree +… more
- SpartanNash (Byron Center, MI)
- …service, utilizing the computer systems to maintain patient profiles and insurance claims , and checking out patients that ensures that the shift contributes to ... take inventory of medications (prescription and over the counter). + Notify Pharmacy Manager of supplies/products that need to be ordered. + Receive… more
- Molina Healthcare (MI)
- …or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to ... as they arise, making an assessment when escalation to a Senior Representative , Supervisor, or another Molina department is needed. Takes initiative in preventing… more
- Henry Ford Health System (MI)
- …with insurance payors regarding authorization issues. May be the hospital representative at external meetings which involve HFH management. + Ensuring that ... prior to claim submission + Managing authorization related denied claims to ensure the highest rate of payment recovery...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more