Top 1065 Plan review Jobs in Lansing, Mi

Encounter Data Specialist
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
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
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
15h
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
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
Housing Quality Standards (HQS) Inspector - Lansing, MI - Part-Time
Quality Inspection Solutions —Lansing, MI
- $20 - $25 an hour
- Part-time
- Ability to walk for extended periods
- Ability to climb stairs
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Virtual Mentor
Engaged Education —Lansing, MI
- $5,000 a year
- Mid-level
- Communication skills
Quick Apply
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
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
Licensed Master Electrician
Absolute Solar —Lansing, MI
- $42 - $55 an hour
- Extended hours
- Background check
- Construction site
- No experience needed
- Paid holidays
- Health insurance
Quick Apply
Physical Therapist - Part Time
Michigan Orthopedic Center —Lansing, MI
- Part-time
- Background check
- Doctoral degree
- Physical & Rehabilitation Medicine
- Flexible schedule
Quick Apply
6d
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
Physical Therapist (Full-Time)
Michigan Orthopedic Center —Lansing, MI
- Full-time
- Background check
- Doctoral degree
- Physical & Rehabilitation Medicine
- Relocation assistance
- Health insurance
Quick Apply
Manufacturing Planner
GNUTTI CARLO —Webberville, MI
- $60,000 - $85,000 a year
- Full-time
- Mid-level
- High school diploma or GED
- In-person
- Health savings account
- Health insurance
Quick Apply
6d
-FULL TIME-Childcare Teacher Assistant
100 Acre Wood Daycare —Holt, MI
- $13.80 - $14.00 an hour
- Full-time
- Background check
- Classroom
- CPR Certification
- Paid time off
- Employee discount
Quick Apply
Director of Investments (Hybrid)
Michigan Catholic Conference —Lansing, MI
- Online Application
- Hybrid work
- 7 years
- Office
- Finance
- AD&D insurance
- Paid holidays
6d

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plan review jobs near lansing, mi

Encounter Data Specialist

Delta Dental of Michigan -
Okemos, MI

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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 lansing, mi

Encounter Data Specialist

Ingham County CPS & Foster Care Services Specialist 9-12

Professional Review Data Researcher

Departmental Manager-3, Internal Control Unit

Social Media Strategist

Departmental Analyst 9-P11 - Grants Management Analyst

Housing Quality Standards (HQS) Inspector - Lansing, MI - Part-Time

Virtual Mentor

Dental Hygienist

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

Physical Therapist

State & Local Tax (SALT) Senior Manager

Contact Center Team Lead (local only considered)

Licensed Master Electrician

Physical Therapist - Part Time

Residential Loan Processor

Physical Therapist (Full-Time)

Manufacturing Planner

-FULL TIME-Childcare Teacher Assistant

Director of Investments (Hybrid)

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

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