• Medical Specialist - Claims

    TEKsystems (Rochester Hills, MI)
    …by telephone or online regarding non-payment or short payment on outstanding claims . Respond to insurance payor correspondence. * Review and resubmit simple ... corrections to low dollar claims to payors for reprocessing. * Work AR aging...Knowledge, Skills, and Abilities: * Experience with HCPC, ICD-10 medical terminology, accounts receivable, insurance collections and payor requirements,… more
    TEKsystems (09/05/24)
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  • Claims Quality Review

    TEKsystems (Rochester Hills, MI)
    Medical Claims Specialist NO PATIENT INTERACTION Address: Rochester Hills, MI 48309 Schedule: Monday - Friday 8am-4:30pm during training and after training ... understand tha basics of EOB's (explanation of benefits) and be familiar with medical claims to be able to recognize what is missing. Essential Duties and… more
    TEKsystems (09/18/24)
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  • Claims Specialist - Workers…

    Crawford & Company (Livonia, MI)
    …the processing of the claim. + Identifies wage loss expenses and wage exposures on medical claims . + Documents receipt and contents of medical reports. ... not exceeding, $2,500 after compensability has been determined. + Evaluates medical claims for potential fraud issues, loss control and recovery in accordance… more
    Crawford & Company (07/09/24)
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  • Medical Billing & Coding Specialist

    Arab Community Center for Economic and Social Serv (Dearborn, MI)
    …Job Summary: Under close supervision, the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided ... Medical Billing & Coding Specialist Department:...at all clinics. Employee is responsible for submitting claims for reimbursement and coach healthcare providers to achieve… more
    Arab Community Center for Economic and Social Serv (09/14/24)
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  • Oncology Pharmacy Tech Specialist

    Trinity Health (Brighton, MI)
    …behavioral care plan in conjunction with the CL Provider and the medical team. Develops goals and interventions in accordance with evidence-based practice and ... outcomes. Reassesses and modifies the plan in collaboration with the CL Providers, medical team and with the patient as necessary to achieve treatment goals.… more
    Trinity Health (08/10/24)
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  • Patient Access Specialist - Part Time…

    Trinity Health (Ypsilanti, MI)
    …insurance, or managed care industries is highly preferred. Experience performing medical claims processing, financial counseling and clearance, or accounting ... for claims processing and maintenance of an accurate electronic medical record. Registers and checks-in patients and determines preliminary patient and insurance… more
    Trinity Health (09/11/24)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …the healthcare industry, including pre-authorization and utilization reviews, along with medical claims processing. + Proven experience in designing multiple ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate will… more
    Integra Partners (08/10/24)
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  • AR Collections Specialist _

    Sevita (Livonia, MI)
    …the people we serve and for our employees. **Accounts Receivable Collections Specialist ** Do you have experience in Accounts Receivable/Collections and a desire to ... impacts the lives of others? In the AR Collections Specialist role, you will contribute to the company's commitment...to the company's commitment to serve others by sending claims to the payer in a timely and accurate… more
    Sevita (08/16/24)
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  • Provider Enrollment Specialist (Corporate…

    Henry Ford Health System (Detroit, MI)
    …collection, analysis of information collected for appropriate enrollment. The Provider Enrollment Specialist must be knowledgeable to work in all aspects of the ... process including initial enrollment, re-credentialing or revalidation. Provider Enrollment Specialist ensures providers are enrolled in accordance with current… more
    Henry Ford Health System (08/21/24)
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  • Certified Risk Adjustment Coding Specialist

    Trinity Health (Livonia, MI)
    …Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST ** **Location:** Trinity Health PACE Corp Michigan **Status:** Full time ... ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from … more
    Trinity Health (09/17/24)
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  • Training Specialist

    Integra Partners (Troy, MI)
    …the healthcare industry, including pre-authorization and utilization reviews, along with medical claims processing. + Proven experience in designing multiple ... The Training Specialist will report to the Manager of Operations...short term disability coverage (location restrictions may apply) + Medical , Vision, and Dental benefits + Paid Time Off… more
    Integra Partners (08/10/24)
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  • ADA Accommodation Specialist

    Sedgwick (Detroit, MI)
    …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer ADA Accommodation Specialist **PRIMARY PURPOSE OF THE ROLE:** To enhance the ADA process for ... claimants requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation requests; and to approve and/or… more
    Sedgwick (09/06/24)
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  • Pharmacy Billing Specialist - Full Time

    Henry Ford Health System (Bingham Farms, MI)
    GENERAL SUMMARY: The Pharmacy Billing Specialist is responsible for the Henry Ford Pharmacy patients account payments and deposits across all pharmacy locations. ... + Provide support to internal and external customers regarding pharmacy copays, claims rejections, rebills, etc. + Verifies patient insurance coverage and makes… more
    Henry Ford Health System (09/10/24)
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  • Quality/Risk Specialist II - Ambulatory…

    Henry Ford Health System (Detroit, MI)
    GENERAL SUMMARY: Under minimal direction, the Quality/Risk Specialist (QRS) II supports the effective surveillance, analysis, and prevention of events which may ... injure patients, lead to malpractice claims , and cause loss to the health care system....multidisciplinary health care teams to reduce and prevent adverse medical outcomes, minimize the risk of injury to patients,… more
    Henry Ford Health System (07/20/24)
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  • Coder Specialist IV

    Trinity Health (Livonia, MI)
    …Patient Business Services (PBS) teams, when needed, to help resolve billing, claims , denial and appeals issues affecting reimbursement. Maintains CEUs as appropriate ... Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) is required. Three (3) years of current acute care… more
    Trinity Health (09/17/24)
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  • HR Operations Coordinator Full Time

    BJs Wholesale Club (Chesterfield, MI)
    …Leave, Jury Duty * Benefit plans for your changing needs* o Three medical plans**, Health Savings Account (HSA), two dental plans, vision plan, flexible spending ... *eligibility requirements vary by position ** medical plans vary by location Job Summary Responsible for supporting administrative functions in the club. Responsible… more
    BJs Wholesale Club (08/13/24)
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  • SO Coder IV Inpatient

    Trinity Health (Livonia, MI)
    …Patient Business Services (PBS) teams, when needed, to help resolve billing, claims , denial, and appeals issues affecting reimbursement. 10. Maintains CEUs as ... Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) is required. Page 3 3. Three (3) years of… more
    Trinity Health (09/11/24)
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