- Molina Healthcare (Detroit, MI)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... Standard Operating Procedures (SOPs). * Responds to provider correspondence related to claims recovery requests and provider remittances where recovery … more
- Carrington (Lansing, MI)
- **Come join our amazing team and work remote from home!** The Sr Claims & Recovery Analysis Loss Specialist is responsible for ensuring the proper ... identified during the Quality Review Process, communicating findings to Loss Specialist for remediation. Ensure Loss Specialist provides corrections as… more
- Sedgwick (Grand Rapids, MI)
- …in Financial Services & Insurance Sr. Claims Specialist , Veterinary Claims | Professional Liability | Remote **PRIMARY PURPOSE** **:** To analyze complex ... or technically difficult veterinary claims ; to provide resolution of highly complex nature and/or...+ Identifies and investigates for possible fraud, subrogation, contribution, recovery , and case management opportunities to reduce total claim… more
- Henry Ford Health System (Troy, MI)
- …of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials ... and follows up on any claims that require a payer response. Responsible for the...Information + Organization: Corporate Services + Department: CBO Insurance Recovery - HB + Shift: Day Job + Union… more
- Molina Healthcare (St. Clair Shores, MI)
- …ancillary) contracts highly desirable. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Certified Recovery Peer Specialist certification required in the state ... **_ Remote and must live in Michigan _** **Job...and timely maintenance of critical provider information on all claims and provider databases. Responsible for contracting/re-contracting of standard… more
- Molina Healthcare (Detroit, MI)
- …for oversight, production, and resolution of health plan payment integrity (PI) recovery concepts. Executes and monitors health plan scoreable action items (SAIs) to ... (CMS) and state regulatory requirements are met for pre-pay edits and overpayment recovery . Manages inventory and works in collaboration with PI team to ensure SAI… more