Top 1085 Plan review Jobs in Saint Johns, Mi

Encounter Data Specialist
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
Compliance Liaison
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Bachelor's degree
- Dental insurance
- Opportunities for advancement
Professional Review Data Researcher
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- Computer Science
- Research
- Mid-level
- Dental insurance
- Opportunities for advancement
12d
Departmental Manager-3, Internal Control Unit
State of Michigan —Lansing, MI
- $35.28 - $52.61 an hour
- Online Application
- Hybrid work
- Management
- Office
- Bachelor's degree
- Paid parental leave
- Health savings account
13h
Departmental Analyst 9-P11 - Grants Management Analyst
State of Michigan —Lansing, MI
- $25.85 - $40.51 an hour
- Online Application
- Hybrid work
- Mid-level
- Office
- Bachelor's degree
- Paid parental leave
- Health savings account
6d
Social Media Strategist
Auto-Owners Insurance Company —Lansing, MI
- Full-time
- Bachelor's degree
- US work authorization
- Entry level
- Paid holidays
- Paid time off
Quick Apply
Ingham County CPS & Foster Care Services Specialist 9-12
State of Michigan —Lansing, MI
- $53,851.20 - $88,608.00 a year
- Full-time
- Mid-level
- Military encouraged
- Paid parental leave
- Health savings account
Instructional Designer I - REMOTE
Ryder System —Lansing, MI
- $65,000 - $75,000 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- Organizational skills
- Disability insurance
- Health insurance
Sr. Transaction Coordinator - Remote or Hybrid
Cushman & Wakefield —East Lansing, MI
- $55,250 - $65,000 a year
- Full-time
- Remote
- Mid-level
- 2 years
- Health savings account
- Disability insurance
Quick Apply
12d
Shiawassee/Gratiot County CPS & Foster Care Services Specialist 9-12
State of Michigan —Owosso, MI
- $52,291.20 - $86,028.80 a year
- Full-time
- Mid-level
- Office
- Military encouraged
- Paid parental leave
- Health savings account
Virtual Mentor
Engaged Education —Lansing, MI
- $5,000 a year
- Mid-level
- Communication skills
Quick Apply
Assistant Director - State Administrative Manager 15
State of Michigan —Lansing, MI
- $46.39 - $66.73 an hour
- Full-time
- Management
- Teaching Certification
- Office
- Paid parental leave
- Health savings account
Lease Admin Coordinator II - REMOTE
Ryder System —Lansing, MI
- $18.25 - $18.50 an hour
- Remote
- Research
- Mid-level
- High school diploma or GED
- Disability insurance
- Health insurance
8d
Dental Hygienist
East Lansing Smiles —East Lansing, MI
- $48 - $53 an hour
- 8 hour shift
- CPR Certification
- Dental office
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
Physical Therapist - Lansing & Holt, MI - New grads & new clinicians WELCOMED!
Orthopaedic Rehab Specialists Physical Therapy —Lansing, MI
- $75,000 - $100,000 a year
- Full-time
- Background check
- Private practice
- Physical & Rehabilitation Medicine
- Profit sharing
- Continuing education credits
Quick Apply
Registered Dietitian - $10k Sign On Bonus Offered to External Candidates!
Memorial Healthcare —Owosso, MI
- Full-time
- Hospital
- Writing skills
- Inpatient
Physical Therapist
HealthQuest Physical Therapy —Michigan
- $75,000 - $90,000 a year
- Full-time
- Physical & Rehabilitation Medicine
- Mid-level
- Master's degree
- Health savings account
- Health insurance
State & Local Tax (SALT) Senior Manager
Rehmann Robson LLC —Lansing, MI
- CPA
- Research
- 8 years
- Paid time off
Quick Apply
Contact Center Team Lead (local only considered)
Renkim Corporation —Michigan
- From $21 an hour
- 8 hour shift
- Remote
- Bilingual
- Customer service
- Computer literacy
- Paid holidays
- Disability insurance
Quick Apply
Residential Loan Processor
First National Bank of America —East Lansing, MI
- Mid-level
- Office
- US work authorization
- Health savings account
- Paid time off
Quick Apply
12d

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plan review jobs near saint johns, mi

Encounter Data Specialist

Delta Dental of Michigan -
Okemos, MI

Apply Now

Job Details

Full-time

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.

Apply Now

Refine Your Search

plan review jobs in saint johns, mi

Encounter Data Specialist

Compliance Liaison

Professional Review Data Researcher

Departmental Manager-3, Internal Control Unit

Departmental Analyst 9-P11 - Grants Management Analyst

Social Media Strategist

Ingham County CPS & Foster Care Services Specialist 9-12

Instructional Designer I - REMOTE

Sr. Transaction Coordinator - Remote or Hybrid

Shiawassee/Gratiot County CPS & Foster Care Services Specialist 9-12

Virtual Mentor

Assistant Director - State Administrative Manager 15

Lease Admin Coordinator II - REMOTE

Dental Hygienist

Physical Therapist - Lansing & Holt, MI - New grads & new clinicians WELCOMED!

Registered Dietitian - $10k Sign On Bonus Offered to External Candidates!

Physical Therapist

State & Local Tax (SALT) Senior Manager

Contact Center Team Lead (local only considered)

Residential Loan Processor

I want to receive the latest job alert for plan review in saint johns, mi

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