- ELECTRICAL COMPONENTS INTERNATIONALHOLDINGS COMPANY (Southfield, MI)
- …Location Southfield Michigan - Southfield, MI Job Category Finance B2B Collections Specialist Electrical Components International (ECI) is seeking a B2B Collections ... Specialist to join our team. Who We Are Founded...delivery discrepancies, or contract compliance issues impacting payment. Dispute Resolution Expertise: Efficiently handle common industry-specific disputes such as… more
- Integra Partners (Troy, MI)
- JOB OVERVIEW Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while ... documentation and account records, as well as timely issue resolution . In this role, you will ensure work is...HIPAA compliance. If you have previous medical billing or claims experience, this role may be of interest as… more
- Lineage Logistics (Novi, MI)
- …the handling of cargo including documents, images, and verbal communication for use in the resolution of claims . + Investigate product claims made by or on ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** + Capture data related to potential claims of overages, shortages, and damages of customer products and unexpected… more
- Molina Healthcare (Sterling Heights, MI)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution ... Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members,… more
- Molina Healthcare (Sterling Heights, MI)
- …Summary** Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider (or authorized ... and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals from Molina members, providers and related… more
- Molina Healthcare (Sterling Heights, MI)
- …for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with ... Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from… more
- Henry Ford Health System (Troy, MI)
- …completeness of patient financial, insurance and demographic information to ensure compliant claims are sent to payers. The Sr. Specialist works independently ... The CBO Insurance Sr. Specialist is responsible for effectively and efficiently resolving...for his/her functional area, coaching team members on account resolution workflows, and assisting the supervisor with team management.… more
- Molina Healthcare (Sterling Heights, MI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of… more
- Sedgwick (Detroit, MI)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance ADA Accommodation Specialist **PRIMARY PURPOSE OF THE ROLE:** To enhance the ADA process for ... key stakeholders regarding progress and status of accommodations; assists in the resolution of any challenges related to the accommodations. + Conducts interactive… more
- Ford Motor Company (Allen Park, MI)
- …maneuvers or during a failed battery state. **3. Quality, Reliability & Problem Resolution :** + Lead the investigation, root cause analysis, and resolution of ... testing), and formal sign-off processes. + **Quality, Reliability & Problem Resolution :** Extensive experience in leading root cause analysis, problem-solving, and … more
- Molina Healthcare (Sterling Heights, MI)
- …for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards ... and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists...**C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service… more
- Trinity Health (Livonia, MI)
- …Term Disability, Military Leave, Family Medical Leave and Workers' Compensation claims with internal areas of expertise and external vendors. Acts independently ... years of progressive experience with increased responsibility in a Disability Analyst/Coordinator/ Specialist or support role, in a high-volume work environment or an… more
- Molina Healthcare (Sterling Heights, MI)
- …of responsibility (eg, Provider Services/Provider Inquiry Research & Resolution , Provider Contracting/Provider Relationship Management). + Provides timely, accurate ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- Molina Healthcare (Sterling Heights, MI)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and finance partners to proactively identify issues and implement resolution strategies. + Serves as a thought partner to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… 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, ... requirements. + Performsnecessary maintenance to patient accounts in the billing and claims editing systems. + Responds timely to all patient and commercial… more
- Trinity Health (Livonia, MI)
- …Patient Business Services (PBS) teams, when needed, to help resolve billing, claims , denials and appeals issues affecting reimbursement. Exhibits awareness of health ... or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate. Utilizes EMR communication tools to track missing… more
- Exotic Automation & Supply (New Hudson, MI)
- …maintain customer contract pricing and pricing matrices. + Coordination with Pricing Specialist on maintenance of item cost and customer price records. + Responsible ... + Maintenance and submission of customer rebates and subsidy claims to Suppliers. + Input/Upload of Supplier Price Updates...Pricing and Sales Management on root cause analysis and resolution + Maintenance of Product Line/Product Codes in system… more
