- CRC Insurance Services, Inc. (MI)
- …job description:** This role is focused on technical claim handling of complex general liability claims , both litigated and non-litigated. This role requires ... affecting primary and excess policies in a fast-paced E&S Claim remote environment 2. Independently evaluating information...and underwriters in the handling and adjudication of all claims 10. Handling complex claims … more
- Lincoln Financial Group (Lansing, MI)
- …You will oversee and ensure the fair, ethical and timely management of more complex claims . If you are passionate about Supplemental Health Claims , ... the processing and administration of all aspects of more complex claims for their assigned area(s) of... claim management. + Approves and makes more complex claim management related financial decisions consistent… more
- Molina Healthcare (Warren, MI)
- **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports Molina's Risk & Quality Solutions (RQS) team by overseeing large programs ... program changes and ensure alignment with program goals. * Resolve complex problems through project management, data analytics, and stakeholder collaboration. *… more
- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** The Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molina's Risk ... effective relationships and gain their trust and respect. * Resolve complex problems through project management, data analytics, and stakeholder collaboration. *… more
- Molina Healthcare (Ann Arbor, MI)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... and Project * Experience partnering with various levels of leadership across complex organizations * Strong quantitative aptitude and problem solving skills *… more
- Molina Healthcare (MI)
- …team of project and/or program managers and is accountable for a complex portfolio of data-improvement activities supporting Molina's Risk & Quality Solution's (RQS) ... to project plans, etc. and develop mitigation strategies. * Resolves complex problems through project management, data analytics, and stakeholder collaboration. *… more
- Trinity Health (Farmington Hills, MI)
- **Employment Type:** Full time **Shift:** **Description:** **POSITION PURPOSE- REMOTE ** Strongly prefer Medical Group billing experience-Professional backgroun ... implements strategies to appropriately maximize reimbursement based delivered services, ensures claims are billed and paid/settled in a timely manner, and… more
- Integra Partners (Troy, MI)
- …time management of claims pricing, revenue cycle management of appealed and denied claims . The RCM Manager will be accountable to identify and generate value ... claims support to teams in reviewing, researching, investigating, processing, and adjusting claims . The RCM Manager will be responsible for Production and… more
- Zurich NA (Lansing, MI)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... claims at the highest authority levels on commercial claim assignments reflecting the highest degree of technical complexity,...expense in analyzing the potential exposure of complex claims . + Ability to determine the… more
- Prime Therapeutics (Lansing, MI)
- …we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value ... or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to… more
- Highmark Health (Lansing, MI)
- …This role provides pre-sale and renewal support to underwriting in evaluating potential claims that impact the risk by providing claim dollar projections on ... + Provide pre-sale and renewal support to underwriting in evaluating potential claims that impact the risk. Claim projections on high dollar claimants… more
- Prime Therapeutics (Lansing, MI)
- …drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides analyses, consults and ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Lansing, MI)
- …**Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Prime Therapeutics (Lansing, MI)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and drives every decision we make. **Job Posting Title** Underwriter - Remote **Job Description** The Underwriter is responsible for assisting in the development… more
- Prime Therapeutics (Lansing, MI)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... leading multiple complex small to mid-sized client and/or product implementations, projects,...Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous… more
- Molina Healthcare (Grand Rapids, MI)
- …accurate and timely maintenance of critical provider information on all claims and provider databases. Responsible for contracting/re-contracting of standard deals, ... negotiations. Minimal ongoing engagement after contract. Synchronizes data among multiple claims systems when applicable, and the application of business rules as… more
- UNUM (Lansing, MI)
- …and join Team Unum today! **General Summary:** The Home Office National Client Manager (HO NCM) is responsible for maintaining a consultative relationship with ... complex group, VB, and integrated customers with 2,000 or...one single large client on the west coast. Existing remote or field office employees are eligible to apply.… more
- University of Michigan (Ann Arbor, MI)
- …and knowledgeable individual whose primary responsibilities will include accurate claim submissions, active collections, resolving complex denials, appeals, ... follow up and payer issues. + Prior experience with No Fault Auto Carrier claims billing. **Work Locations** **THIS IS A REMOTE POSITION.** The onsite location,… more
- City of Detroit (Detroit, MI)
- Director of Internal Audit (Auditor Manager 3) Print (https://www.governmentjobs.com/careers/detroit/jobs/newprint/4745404) Apply Director of Internal Audit ... (Auditor Manager 3) Salary $105,064.00 - $137,796.00 Annually Location Michigan,...Annually Location Michigan, MI Job Type Certified-Regular Civil Service Remote Employment Flexible/Hybrid Job Number 20240213201123OCFOJS Department Off Chf… more
- Sedgwick (Grand Rapids, MI)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Field Case Manager **This Field Case Manager will cover our Lansing, and Kalamazoo, ... knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness...on the health and lives of others, and a remote work environment that allows face to face interaction… more