- Area Agency On Aging 1-b (Southfield, MI)
- The Appeals and Compliance Specialist is responsible for providing comprehensive responses in compliance with contract, regulatory and accreditation ... during the administrative hearing process. Works closely with the Compliance Officer and is an active member of the...communicate disposition of case . + Triages case inquiries, appeals , and prepares case files/packets for appeal hearings. Attend… more
- R1 RCM (Detroit, MI)
- …operating costs and enhancing the patient experience. As our Revenue Integrity specialist , you will be responsible for key operational functions to include charge ... capture, clinical billing, appeals and advanced third-party or government audits. Every day...as a clinical Subject Matter Expert for regulatory and compliance as it pertains to Revenue Cycle Management (RCM).… more
- University of Michigan (Ann Arbor, MI)
- Clinical Documentation Integrity Specialist III Apply Now **Job Summary** This Clinical Documentation Integrity Specialist III (CDIS III) position is fully ... accuracy of patient outcomes, PSI90/HAC reviews, clinical denials and appeals and complexity of patient care. Serves as key...+ Performs audits on CDIS to ensure quality and compliance . + In collaboration with leadership & CDI Coordinator,… more
- University of Michigan (Ann Arbor, MI)
- Prior Authorization Specialist Apply Now **Job Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... follow-up actions in response to information obtained and document outcomes for appeals as needed. + Other duties as assigned. **Required Qualifications + Associate… more
- Trinity Health (Livonia, MI)
- …(PBS) teams, when needed, to help resolve billing, claims, denial and appeals issues affecting reimbursement. Maintains CEUs as appropriate for coding credentials as ... coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and… more
- Trinity Health (Livonia, MI)
- …(PBS) teams, when needed, to help resolve billing, claims, denial and appeals issues affecting reimbursement. Maintains CEUs as appropriate for coding credentials as ... coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and… more
- Trinity Health (Livonia, MI)
- …(PBS) teams, when needed, to help resolve billing, claims, denial, and appeals issues affecting reimbursement. 10. Maintains CEUs as appropriate for coding ... coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and… more