- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. **Position Summary** A payer analyst role involves understanding basic concepts of ... issues with payors when necessary. **Essential Responsibilities** Responsibilities of a plan/ payer escalation specialist include but are not limited to the ability… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our R37 GenAI Lab Process Analyst in the Perfect Claim pillar, you will play a key role in both ... enabled product platform. **Here's what you will experience working as a Process Analyst :** + Analyze and optimize current edits in claim scrubbers to improve claim… more
- R1 RCM (Detroit, MI)
- …while reducing operating costs and enhancing the patient experience. As our Hospital CDM Analyst / RIS Analyst you will ensure accurate and optimal revenue ... are accurate and compliant with coding guidelines. Reimbursement Review: + Analyze payer contracts and reimbursement rates to ensure that services are billed and… more
- Henry Ford Health System (Detroit, MI)
- …PRINCIPLE DUTIES AND RESPONSIBILITIES: 1. Responsible for building basic payer /plan-specific contract terms, including common reimbursement methodologies. 2. Achieve ... and analyzing issues for areas of opportunities. 6. Escalate payer contract non-compliance issues to contract administrators/consultants EDUCATION/EXPERIENCE REQUIRED:… more
- Trinity Health (Livonia, MI)
- …to home office third party cost reports, third party appeals, third party payer contract negotiations, analysis of financial impact of changes in third party ... models and analyses to assure proper reimbursement. Participates in third-party payer preparing impact analysis and recommendations. Participates in developing and… more
- Molina Healthcare (Detroit, MI)
- …acceptable. **REQUIRED EXPERIENCE:** + 1-3 years of experience in Healthcare ( payer experience), Vendor Management, Data Analytics, Contract Terms and Conditions, ... Procurement, Project Management, or Account Management + Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas. + Proficient with Microsoft Office Suite, databases, advanced spreadsheets, pivot… more