- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** ** Claims Analyst ** **Location:** Trinity Health PACE Corp Michigan, Livonia, MI **Status:** Full time ... HYBRID, will work in the office each Wednesday. **Position Purpose:** The Claims Analyst is responsible for analyzing and reviewing claims for accuracy,… more
- Deloitte (Detroit, MI)
- …who wants to work in a collaborative environment? As an experienced Epic Billing and Claims Senior Analyst you will have the ability to share new ideas and ... + Certified in Epic Hospital Billing Administration/Professional Billing Administration and Claims + Experience in performing configuration changes and system builds… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Sterling Heights, MI)
- …review of production support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains understanding of solution ... functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received on … more
- Molina Healthcare (Sterling Heights, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our Denials & AR Analyst I, you will help R1 clients by analyzing claims information ... Prior Denials or AR experience in Hospital or Physician claims and experience working in a production-based environment is...you will experience working as a Denials & AR Analyst I:** + You will be investigating and analyzing… more
- Elevance Health (Dearborn, MI)
- **Test Analyst - Pharmacy Benefit Management (PBM)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The **Test Analyst (Business Analyst III)** will be responsible for serving as… more
- Molina Healthcare (Sterling Heights, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Henry Ford Health System (Troy, MI)
- Reporting to the CDM Manager, the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the ... accuracy and completeness of the CDM. The CDM Analyst also supports the CDM Coordinator and Senior CDM...+ EPIC certification in CDM Management, PB or HB Claims certified preferred. + If not EPIC CDM certified,… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. The Product Support Analyst II - Revenue Cycle Digital Solutions is a pivotal role ... with IT to manage Electronic Data Interchange (EDI) transactions, including claims (837), electronic remittances (835), claim status inquiries, and eligibility… more
- Molina Healthcare (Sterling Heights, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... strong experience with Benefits and contracts configuration in QNXT + Must have claims processing experience + Knowledge is SQL + Experience is Excel is required… more
- Molina Healthcare (Sterling Heights, MI)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- Molina Healthcare (Sterling Heights, MI)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more
- Molina Healthcare (Sterling Heights, MI)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides daily operational ... manages email correspondence between vendors, functional counterparts, and stakeholders ( Claims , Enrollments, IT, Health Plan, Core Operations) + Performs… more
- Trinity Health (Livonia, MI)
- …service line data. Collects, analyzes and summarizes market, financial, clinical and claims data from publicly available, vendor supplied, and internal sources as ... capital and operating budget process; Identifying trends or patterns in complex claims data. Develops and communicates ongoing assessment of healthcare business and… more
- Truist (Bloomfield Hills, MI)
- …or improvements. + Analyze and support the processing of proceeds from insurance loss claims . + Support the collection of delinquent loan payments, as well as the ... reporting of same. + Assist in the accurate and timely maintenance of the loan servicing system database regarding the loan accounting records, collateral-and borrower-related records, or other relevant records. + Identify and report borrower breaches of loan… more
- McLaren Health Care (Shelby Township, MI)
- …and human resources. **BILLING:** Responsible for billing hospital and physician claims , for inpatients and outpatients treated in the hospital and clinic, ... Performsnecessary maintenance to patient accounts in the billing and claims editing systems. + Responds timely to all patient...and insurance companies to resolve bill/claim edits. + Notify Analyst of edits that needs to be built and… more
- Molina Healthcare (Sterling Heights, MI)
- …staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory ... management or team leadership experience + 10 years' work experience preferable with claims data and/or healthcare environment + Strong knowledge of Excel, SQL, and… more
- Insight Global (Auburn Hills, MI)
- …in troubleshooting and diagnosing technical issues regarding product support, warranty claims , or maintenance products on medium and heavy-duty truck and trailer ... customer support, technical support, store manager, parts manager, or warranty analyst * Automotive Electrical Component Experience: understanding of brakes, engine,… more