Jobs
>
Detroit

    Claims Analyst - Detroit, United States - LanceSoft

    LanceSoft
    LanceSoft Detroit, United States

    1 day ago

    Default job background
    Description
    Engagement Description
    • Reviewing claim submissions and verifying claims processed correctly.
    • Auditing claims-making sure the system applied the correct benefits, pricing, and cost share values.
    • Comparing claims data to the members benefits and other policy documents.
    • Ensuring the system applied to correct allowed amounts using Client fee schedules.
    • Confirmed system applied the correct member cost share amounts based on benefit documents.
    • Performing other clerical tasks, as required.
    Top 3 Required Skills/Experience
    • 5 years medical claims experience (HCFA and Banking)
    • In depth knowledge of medical claim coding
    • Proficient in Microsoft Word and Excel
    Required Skills/Experience:
    • Excellent critical thinking and decision-making skills.
    • Good administrative and organizational skills.
    • Ability to work under pressure, perform a range of clerical functions with great attention to detail.
    • Medicare claims and compliance experience
    • Comfortable working independently
    • Understands the importance of deadlines
  • CapRelo

    Claims Analyst

    1 day ago

    CapRelo Sterling, United States

    Overview: · As a Household Goods Moving Claims Analyst, you will play a pivotal role in ensuring customer satisfaction and managing claims associated with household goods relocation services. You will be responsible for investigating and resolving claims filed by customers relat ...

  • Cherokee Insurance Company

    Claims Analyst

    8 hours ago

    Cherokee Insurance Company Sterling Heights, United States

    Cherokee Insurance, a leading commercial Property/Casualty insurance provider, is currently in search of an Insurance Adjuster to work on-site at our corporate office located in Sterling Heights, MI. We are looking for highly detailed, analytical and assertive individuals to assi ...

  • ADN Administrators, Inc.

    Dental Claim Analyst/Processor

    1 day ago

    ADN Administrators, Inc. Bingham Farms, United States

    Job Description · Job DescriptionWe are a Third-Party Claim Administrator seeking persons to analyze, and process claims for members in dental claim programs. Prior experience in dealing with dental insurance claims is preferrable and additional training is provided. This is a fu ...

  • Strategic Staffing Solutions

    Healthcare Analyst

    5 hours ago

    Strategic Staffing Solutions Detroit, United States

    STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING · Strategic Staffing Solutions is currently looking for a Healthcare Analyst for a contract opportunity with one of our largest clients located in Detroit, MI · Title: Healthcare Analyst · Location: Detroit, MI (Remote however must ...

  • Strategic Staffing Solutions

    Healthcare Analyst

    1 day ago

    Strategic Staffing Solutions Detroit, United States

    STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING · Strategic Staffing Solutions is currently looking for a Healthcare Analyst for a contract opportunity with one of our largest clients located in Detroit, MI · Title: Healthcare Analyst · Location: Detroit, MI (Remote however mu ...

  • Tekwissen

    Business Analyst

    4 days ago

    Tekwissen Detroit, United States

    Overview: · Tek Wissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, pla ...

  • Omni Inclusive

    Data Analyst

    4 days ago

    Omni Inclusive Detroit, United States

    Job summary Working closely with clients, business analysts and team members to understand the business requirements that drive the analysis and technical solutions (Data mapping). These solutions must be aligned with business and IT strategies and in compliance with the organiza ...

  • Gtech Services

    Senior Health Care Analyst

    18 hours ago

    Gtech Services Detroit, United States Paid Work

    Responsible for planning, organizing, directing, implementation, and leading department assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Research, compile and analyze appropriate and relevant data and make recommendation ...

  • OpTech

    Data Analyst

    1 day ago

    OpTech Detroit, United States

    Our amazing client is looking for a Data Analyst for an exciting long term project with a great team. This team is working Hybrid in Michigan and going to the office a minimum of once a week. We know this client well and can share great insight. Very exciting work being done with ...

  • Molina Healthcare

    Medical Director-Based in Michigan

    1 day ago

    Molina Healthcare Detroit, United States

    **JOB DESCRIPTION** · **Job Summary** · Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and procedures that guide and support the provisions of medical staff services. Maintain ...

  • WPS Health Solutions

    Prior Authorization Nurse Analyst

    1 hour ago

    WPS Health Solutions Detroit, United States

    Who We Are · is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide custome ...

  • Wayne State

    System Security Specialist, C&IT

    4 days ago

    Wayne State Detroit, United States

    System Security Specialist, C&IT · Wayne State University is searching for an experienced System Security Specialist, C&IT at its Detroit campus location. · Wayne State is a premier, public, urban research university located in the heart of Detroit, Michigan where students from a ...

  • Strategic Staffing Solutions

    Sr. Health Care Analyst Contract Detroit MI2 days ago

    3 days ago

    Strategic Staffing Solutions Detroit, United States Contract

    STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING · Strategic Staffing Solutions is currently looking for a Sr. Health Care Analyst for a contract opportunity with one of our largest clients located in Detroit, MI · Title: Sr. Health Care Analyst · Location: Detroit, MI (Remote) ...

  • R1 RCM

    Denials & AR Analyst II

    4 days ago

    R1 RCM Detroit, United States Paid Work

    R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1 is a publicly-traded organization with employees throughout the US ...

  • R1 RCM

    Revenue Cycle Analyst Underpayments

    4 days ago

    R1 RCM Detroit, United States Paid Work

    As our Underpayments Analyst you have the primary role of validating and reviewing hospital accounts which are believed to have additional revenue opportunity. Every day you will confirm claim reimbursement, ensure there are no additional variables impacting reimbursement, diagno ...

  • WTW

    Healthcare Financial/Actuarial Analyst

    6 hours ago

    WTW Detroit, United States Full time

    Candidates in any of the following locations will be considered: · Chicago, IL, Nashville, TN, Pittsburgh, PA · As a Healthcare Financial/Actuarial Analyst you will support a wide variety of projects involving the design, funding, and measurement and financial analysis of the ful ...

  • Willis Towers Watson

    Healthcare Financial/Actuarial Analyst

    6 days ago

    Willis Towers Watson Detroit, United States Full time

    Job Description · Candidates in any of the following locations will be considered: · Chicago, IL, Nashville, TN, Pittsburgh, PA · As a Healthcare Financial/Actuarial Analyst you will support a wide variety of projects involving the design, funding, and measurement and financial a ...

  • WTW

    Healthcare Financial/Actuarial Analyst

    1 week ago

    WTW Detroit, United States Paid Work

    Candidates in any of the following locations will be considered: · Chicago, IL, Nashville, TN, Pittsburgh, PA · As a Healthcare Financial/Actuarial Analyst you will support a wide variety of projects involving the design, funding, and measurement and financial analysis of the ful ...

  • Wayne State University

    System Security Specialist, C&IT

    4 weeks ago

    Wayne State University Detroit, United States Paid Work

    System Security Specialist, C&IT · Wayne State University is searching for an experiencedSystem Security Specialist, C&ITat its Detroit campus location. · Wayne State is a premier, public, urban research university located in the heart of Detroit, Michigan where students from all ...

  • Compu-Vision Consulting

    Mainframe Developer

    5 days ago

    Compu-Vision Consulting Hamtramck, United States

    Title: Mainframe Developer · Location: Detroit, MI(Onsite/Hybrid) · Duration: 12+ Months · The best rate we have for this role is $60-65/hr on C2C · Check also if no one is submitted in last 6 months · Top Three Skills/Experience · 1. Strong hands-on experience designing, develop ...