- Henry Ford Health System (Troy, MI)
- …provider appeals, for all product lines (HMO, AHL, and Medicare Advantage (MA), Medicaid , and Duals) in accordance with internal HAP policies. Coordinate with the ... regulatory mandates including NCQA, Department of Labor (DOL) and Center for Medicare/ Medicaid Services (CMS). Maintain formal history of provider appeals and the … more
- Henry Ford Health System (Troy, MI)
- …finance background, preferred. Ability to work with and interpret detailed medical record documents and communicate effectively with physician, nursing staff, ... leadership and other HFH personnel. + Knowledge of medical coding (facility and professional), related medical terminology, use of medical records, facility… more
- Henry Ford Health System (Troy, MI)
- …processes within value-based reimbursement models and initiatives. Reporting to the Director , Risk Adjustment and Value-Based Payment, the Program Manager is ... both departmental staff and multi-disciplinary teams. + Knowledge of Medicare, Medicaid , Blue Cross and other third-party payers billing and reimbursement… more
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