- Prime Therapeutics (Lansing, MI)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Appeals Coordinator **Job Description** + Maintains a caseload and monitors day to ... medical necessity reviews. + Enters all data related to appeals and case reviews into a database. + Prepares...into a database. + Prepares and presents information on appeals to panels second-level multi-disciplinary committee. + Participates in… more
- G-TECH Services, Inc. (Detroit, MI)
- Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established regulatory and accreditation guidelines. ... Skills/Experience - Optional but preferred skills/experience. Include: * Grievance and Appeals experience. * Degree in Healthcare/computer skills * Experience in… more
- University of Michigan (Ann Arbor, MI)
- Patient Services Intermediate, Referral Coordinator for Cardiac Rehabilitation Apply Now **How to Apply** Excellent service is expected and an internal part of the ... Cardiovascular Medicine Clinic at Domino's Farms is seeking a Referral Coordinator to coordinate and facilitate communication between referring physicians, managed… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing Utilization ... Management prior authorization sand appeals . JOB RESPONSIBILITIES + Monitor incoming faxes + Enter...expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment preferred +… more
- Cardinal Health (Lansing, MI)
- …to Cardinal Health_** The Sr. Coord, Individualized Care (Reimbursement Coordinator ) supports patient access to therapy through Reimbursement Support Services ... * Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
- Cardinal Health (Lansing, MI)
- …documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Knowledge of Medicare, Medicaid and Commercially insured ... payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of Medical/Pharmacy billing and coding is preferred + Important to… more
- Corewell Health (Farmington Hills, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... appropriate reimbursement. Determines and assures appropriate status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. + Routinely communicates with payers,… more
- Cardinal Health (Lansing, MI)
- …Events and follow process for timely submission. Review all requests for appeals and ensure supporting documentation is present. Support team with call overflow ... when needed. Ability to mediate situations in which parties are in disagreement and facilitate a positive outcome. Effectively be able to multitask daily tasks and workload. + **TRAINING AND WORK SCHEDULES** : Your new hire training will take place… more
- Corewell Health (Royal Oak, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... appropriate reimbursement. Determines and assures appropriate status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5. Routinely communicates with payers,… more
- Origami Brain Injury Rehabilitation Center (Mason, MI)
- …leadership of the Business Office Manager, in addition to the admissions and care coordinator teams, you'll act as a vital liaison between funding sources and the ... Origami team. Your responsibilities will include processing initial appeals and redeterminations, ensuring timely and accurate filing of utilization review… more
- University of Michigan (Ann Arbor, MI)
- …FTE position is dedicated to 100% patient care as a pharmacy financial coordinator within the specialty pharmacy program. This position reports directly to the PFC ... Supervisor. Characteristic Duties and Responsibilities The patient financial coordinator (PFC) will coordinate medication access and financial assistance for… more
- State of Michigan (Lansing, MI)
- …criminal case from the pre-charging stage all the way through post-conviction appeals , most importantly by serving as the liaison between the Assistant Attorneys ... in the application or selection processes, please contact theADA coordinator (https://www.michigan.gov/ose/-/media/Project/Websites/ose/Contact/RACs.pdf) for the agency that posted this position… more