Top 268 Claims specialist Jobs in Michigan

Encounter Data Specialist
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
5d
PIP Claim Specialist - Michigan
ACS Auto Club Services, Inc. —Michigan
- $65,700 - $87,600 a year
- Weekends as needed
- Hybrid work
- Anatomy knowledge
- Surgery
- Pass drug screening
- Paid jury duty
- Health savings account
4d
Remote Claims Support Specialist
Latitude Subrogation Services —Bloomfield Hills, MI
- Full-time
- Remote
- Entry level
- Disability insurance
- Health insurance
Quick Apply
8d
Senior Claim Benefit Specialist - Remote
CVS Health —Michigan
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
14d
Senior Claims Specialist
Liberty Mutual —Detroit, MI
- $79,000 - $129,000 a year
- Full-time
- 7 years
- Up to 50% travel
- Analysis skills
5d
CBO Billing Specialist - Full Time Days - Remote (Michigan Residents)
Henry Ford Health —Troy, MI
- Full-time
- Remote
- Medical office experience
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —Michigan
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
12d
Claims Follow-up Specialist
MOBILE MEDICAL RESPONSE INC —Saginaw, MI
- Full-time
- 18 years or older
- Microsoft Excel
- Computer literacy
EDI Integration Specialist
Advanced Rehab Management Services —Grand Blanc, MI
- $65,000 - $70,000 a year
- Full-time
- Background check
- Salesforce
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Human Resources Specialist
Helen Newberry Joy Hospital —Newberry, MI
- Full-time
- Hospital
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
Patient Support Specialist
Total Respiratory & Rehab —Marquette, MI
- Overtime
- Background check
- Microsoft Outlook
- Ability to walk for extended periods
Quick Apply
9d
Medical Billing and Authorization Specialist
Muskegon Surgical Associates, PC —Muskegon, MI
- Full-time
- Background check
- Surgery
- Medical office experience
Quick Apply
Damage Specialist
Project Resources Group —Saginaw, MI
- $51,000 - $54,000 a year
- Overtime
- Hybrid work
- Microsoft Word
- Ability to walk for extended periods
- Mid-level
- Mileage reimbursement
- Paid holidays
Quick Apply
6d
Benefits Senior Specialist
Hinton Transportation Investments —Byron Center, MI
- $75,000 - $100,000 a year
- Full-time
- Hybrid work
- 5 years
- Research
- Office
Quick Apply
Dental Billing Specialist
West Michigan Oral Surgery —Holland, MI
- Full-time
- Surgery
- Customer service
- Mid-level
- Profit sharing
- Health insurance
Quick Apply
12d
Corporate Insurance & Risk Management Specialist (Contract)
Digitive LLC —Grand Blanc, MI
- $60 - $65 an hour
- 8 hour shift
- 7 years
- Bachelor's degree
- Business Administration
Quick Apply
2nd Shift Safety, Health & Environmental Specialist
Nestlé Nutrition —Fremont, MI
- Microsoft Word
- Microsoft Excel
- Mid-level
5d
Safety, Health & Environmental Specialist
Nestlé Nutrition —Fremont, MI
- Microsoft Word
- Microsoft Excel
- Mid-level
10d
Claims Specialist
MSX International —Dearborn, MI
- Full-time
- Microsoft Word
- Analysis skills
- Organizational skills
Quick Apply
Insurance Verification Specialist
My Community Dental Centers Inc. —Petoskey, MI
- $19 - $21 an hour
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Wellness program
- Paid holidays
4d

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claims specialist jobs near michigan

Encounter Data Specialist

Delta Dental of Michigan -
Okemos, MI

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Job Details

Full-time
5 days ago

Benefits

Dental insurance
Opportunities for advancement

Qualifications

Benefits administration
Word processing
Spreadsheets
Bachelor's degree
Desktop applications
Productivity software
Health insurance management

Full Job Description

Job Title:

Encounter Data Specialist

Number of Positions:

Location:

Okemos, MI

Location Specifics:

Hybrid Position

Job Summary:

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Position Description:

Analyzes, corrects, and recommends solutions to internal and external stakeholders regarding encounter data issues, policies, processes, requirements, and records.

Primary Job Responsibilities:

Corrects rejected encounters in compliance with internal and external processing guidelines and best practices.
Researches, reviews, and interprets encounter data to identify potential issues and address rejected records.
Monitors, manages, and audits encounter submissions to ensure timely and accurate file submission and processing.
Develops, maintains, and updates all encounter policies and procedures.
Monitors related processes to ensure internal and external requirements are met, partners with functional areas to maintain claims system support tables, and performs data entry or general data maintenance for eligibility, providers, fee sets, and benefits for related records.
Conducts root cause analysis for encounter errors reviews results, processes, and/or system programming with other departments to minimize repeat issues.
Creates and maintains an encounter error library, policies and procedures to correct rejected encounters, and daily and weekly reports.
Analyzes trends of rejected encounters, identifies opportunities for improvement, and recommends solutions.
Develops and tests internal audit and Integrated Data Management reports to prevent rejections and oversees the completion of audit reports in other departments.
Establishes and maintains strong relationships with internal and external plans, partners, and other stakeholders to correct, prevent, and resolve encounter errors.
Serves as a subject matter expert and internal consultant on encounter data, policies, processes, corrections, and provides training to internal stakeholders regarding regulatory changes.
Leads and participates in encounter data and compliance meetings as assigned.
Oversees compliance with data integrity policies for all system configurations.

Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

#LI-Hybrid

Minimum Requirements:

Position requires a bachelor’s degree in business administration or a related field and five years of experience identifying, analyzing, or resolving business, system, or process issues in the administration of health plan benefits. Previous experience in the administration of Medicare and/or Medicaid programs and Centers for Medicare and Medicaid regulations and guidelines is preferred. Will accept any suitable combination of education, training, or experience.

Position requires knowledge of word processing, spreadsheet, presentation, and database applications; strong verbal and written communication skills; strong analytical skills; the ability to work independently and as part of a team; the ability to manage multiple assignments with competing deadlines; and the ability to identify and resolve complex problems using independent judgement.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

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Refine Your Search

claims specialist jobs in michigan

Encounter Data Specialist

PIP Claim Specialist - Michigan

Remote Claims Support Specialist

Senior Claim Benefit Specialist - Remote

Senior Claims Specialist

CBO Billing Specialist - Full Time Days - Remote (Michigan Residents)

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Claims Follow-up Specialist

EDI Integration Specialist

Human Resources Specialist

Patient Support Specialist

Medical Billing and Authorization Specialist

Damage Specialist

Benefits Senior Specialist

Dental Billing Specialist

Corporate Insurance & Risk Management Specialist (Contract)

2nd Shift Safety, Health & Environmental Specialist

Safety, Health & Environmental Specialist

Claims Specialist

Insurance Verification Specialist

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