Fully Remote Job Summary: Candidates must reside in Michigan within a reasonable commuting distance ... local law or ordinance.
Fully Remote Job Summary: Candidates must reside in Michigan within a reasonable commuting distance ... local law or ordinance.
Fully Remote Job Summary: Candidates must reside in Michigan within a reasonable commuting distance ... local law or ordinance.
Fully Remote Job Summary: Candidates must reside in Michigan within a reasonable commuting distance ... local law or ordinance.
Chief Capital Architect & Ecosystems Officer
Detroit, MI ยท On-site +1
$210K - $275K/yr
T/W | Remote: M/Th/F Department Function: The Capital Architecture & Ecosystem function is ... Maintain strategic relationships with key federal, state, and local government actors, philanthropy ...
Chief Capital Architect & Ecosystems Officer
Detroit, MI ยท On-site +1
$210K - $275K/yr
T/W | Remote: M/Th/F Department Function: The Capital Architecture & Ecosystem function is ... Maintain strategic relationships with key federal, state, and local government actors, philanthropy ...
Remote in Michigan available QUALIFICATIONS: Education: Bachelor's degree in accounting, finance ... Minimum of 3 - 5 years' experience in fund accounting or school / government audits Supervisory ...
Remote in Michigan available QUALIFICATIONS: Education: Bachelor's degree in accounting, finance ... Minimum of 3 - 5 years' experience in fund accounting or school / government audits Supervisory ...
... Government entities, Police Services, Insurance, Financial, and Travel & Hospitality ... In addition, employees are entitled to earn paid sick leave under the applicable state or local ...
... Government entities, Police Services, Insurance, Financial, and Travel & Hospitality ... In addition, employees are entitled to earn paid sick leave under the applicable state or local ...
... Government entities, Police Services, Insurance, Financial, and Travel & Hospitality ... In addition, employees are entitled to earn paid sick leave under the applicable state or local ...
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... Government entities, Police Services, Insurance, Financial, and Travel & Hospitality ... In addition, employees are entitled to earn paid sick leave under the applicable state or local ...
Senior Consultant
Ann Arbor, MI ยท On-site +1
Senior Consultant - Remote About Pyrovio Pyrovio is a growing management consulting firm that helps ... We partner with clients across private, public, and government sectors-including Fortune 500 ...
Senior Consultant
Ann Arbor, MI ยท On-site +1
Senior Consultant - Remote About Pyrovio Pyrovio is a growing management consulting firm that helps ... We partner with clients across private, public, and government sectors-including Fortune 500 ...
WI Commercial Searcher (Remote)
Wyoming, MI ยท On-site +1
$23.37 - $31.15/hr
... and other government entities to perform the searches. Assignments are varied and complex and ... local laws (e.g., the Los Angeles County Fair Chance Ordinance for Employers and the California ...
WI Commercial Searcher (Remote)
Wyoming, MI ยท On-site +1
$23.37 - $31.15/hr
... and other government entities to perform the searches. Assignments are varied and complex and ... local laws (e.g., the Los Angeles County Fair Chance Ordinance for Employers and the California ...
$23.37 - $31.15/hr
... and other government entities to perform the searches. Assignments are varied and complex and ... local laws (e.g., the Los Angeles County Fair Chance Ordinance for Employers and the California ...
$23.37 - $31.15/hr
... and other government entities to perform the searches. Assignments are varied and complex and ... local laws (e.g., the Los Angeles County Fair Chance Ordinance for Employers and the California ...
Staff Attorney Administrative Hearings - OrderID: 4282
Grand Rapids, MI ยท On-site +1
$41.75 - $43.75/hr
A prestigious government agency is addressing the backlog of special education claims in New York ... Remote Work Skills: Dedicated workspace, reliable Wi-Fi, and comfort with virtual tools like ...
Quick apply
Staff Attorney Administrative Hearings - OrderID: 4282
Grand Rapids, MI ยท On-site +1
$41.75 - $43.75/hr
A prestigious government agency is addressing the backlog of special education claims in New York ... Remote Work Skills: Dedicated workspace, reliable Wi-Fi, and comfort with virtual tools like ...
Senior Business Analyst
Jackson, MI ยท On-site +1
$82K - $107K/yr
Mississippi (Remote) Position Overview This role requires deep experience working with government ... Minimum ten (10) years of experience working as a Business Analyst for state, local, or corporate ...
Senior Business Analyst
Jackson, MI ยท On-site +1
$82K - $107K/yr
Mississippi (Remote) Position Overview This role requires deep experience working with government ... Minimum ten (10) years of experience working as a Business Analyst for state, local, or corporate ...
Homeless Education Program Consultant - School District Consultant 11-P13
Lansing, MI ยท On-site +1
$65K - $106K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-106DC Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Homeless Education Program Consultant - School District Consultant 11-P13
Lansing, MI ยท On-site +1
$65K - $106K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-106DC Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Assistant Director - State Administrative Manager 15
Lansing, MI ยท On-site +1
$46.39 - $66.73/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-096TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Assistant Director - State Administrative Manager 15
Lansing, MI ยท On-site +1
$46.39 - $66.73/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-096TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Reimbursement Specialist
Walker, MI ยท On-site +1
$24 - $26/hr
Hiring a Remote Reimbursement Specialist role! Schedule: M-F 7-4 PM or 8-5 PM PST Pay Range: $24 ... Experience working a mix of commercial and government payers, and utilizing both calls and portals ...
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Reimbursement Specialist
Walker, MI ยท On-site +1
$24 - $26/hr
Hiring a Remote Reimbursement Specialist role! Schedule: M-F 7-4 PM or 8-5 PM PST Pay Range: $24 ... Experience working a mix of commercial and government payers, and utilizing both calls and portals ...
Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity ... government and third- party payer regulations. Must understand and have expertise with Patient ...
Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity ... government and third- party payer regulations. Must understand and have expertise with Patient ...
Staff Attorney
Detroit, MI ยท On-site +1
$55K - $66K/yr
Providing court representation, which may include physical, as well as remote appearances in state ... Drafting and filing legal documents with the appropriate government agencies. * Collecting and ...
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Staff Attorney
Detroit, MI ยท On-site +1
$55K - $66K/yr
Providing court representation, which may include physical, as well as remote appearances in state ... Drafting and filing legal documents with the appropriate government agencies. * Collecting and ...
Perkins Quality Indictor Education Research Consultant 14
Lansing, MI ยท On-site +1
$38.80 - $54.91/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-051TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Perkins Quality Indictor Education Research Consultant 14
Lansing, MI ยท On-site +1
$38.80 - $54.91/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-051TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Engineer Manager Licensed 14 (Construction Engineer) - Detroit TSC
Lansing, MI ยท On-site +1
$47.12 - $68.17/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 5901-26-MR-7-EML14-DTSC-AP ... Initiating and maintaining contact with local communities to jointly review and resolve ...
Engineer Manager Licensed 14 (Construction Engineer) - Detroit TSC
Lansing, MI ยท On-site +1
$47.12 - $68.17/hr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 5901-26-MR-7-EML14-DTSC-AP ... Initiating and maintaining contact with local communities to jointly review and resolve ...
Alternate Assessment Psychometrician - Education Research Consultant 15B
Lansing, MI ยท On-site +1
$93K - $131K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-25-049TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Alternate Assessment Psychometrician - Education Research Consultant 15B
Lansing, MI ยท On-site +1
$93K - $131K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-25-049TH Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Accounting Technician 10
Lansing, MI ยท On-site +1
$48K - $73K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-110DC Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Accounting Technician 10
Lansing, MI ยท On-site +1
$48K - $73K/yr
Permanent Full Time Remote Employment: Flexible/Hybrid Job Number: 3103-26-110DC Department ... MDE is responsible for state education leadership in a local control state and works to implement ...
Remote Local Government information
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Government Programs Professional Review Claims Specialist
Delta Dental of MichiganOkemos, MI โข On-site, Remote
Full-time
Medical, Dental
Posted 2 days ago
Job description
Government Programs Professional Review Claims Specialist
Number of Positions:
1
Location:
Okemos, MI
Location Specifics:
Fully Remote
Job Summary:
Candidates must reside in Michigan within a reasonable commuting distance of our Okemos, MI office for team meetings, collaborative sessions, and training.
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
To analyze and adjudicate dental claims with complicated treatment plans to ensure accurate benefits administration.
Primary Job Responsibilities
- Analyzes and processes dental claims so appropriate determinations can be finalized with correct procedures, policies, and bypasses; adjudicates claims, and maintains claim records.
- Administers claim processing guidelines/standards, Delta USA processing policies, group contracts, provider agreements, and state laws applicable to claims adjudication.
- Investigates difficult provider reconsideration requests, makes determinations, performs or coordinates adjustments; prepares claims for a second and/or third opinion when necessary and consults with contracted dentists on questionable treatment cases.
- Pre and post-screens claims and/or inquiries for dental consultant(s); reviews and prepares claims for and coordinates external dental consultant activities.
- Provides dental expertise and/or interpretation of dental policies, procedures codes, and processing guidelines to internal and external contacts.
- Organizes, creates, and performs defined test cases on claims processing system, and documents/reports status of testing including recommendations for improvements. Analyzes and compiles information/data for reports to control and/or monitor claims inventory.
- Researches, coordinates, and adjudicates Third Party Liability claims and recoveries; compares member information, prepares claims, and performs adjustments as necessary to ensure proper Third Party Liability (COB) adjudication.
Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
#LI-Remote
Minimum Requirements:
Position requires an associate's degree, technical, vocational, or business school with coursework related to dentistry, two years of experience in chair side assisting, and a RDA or RDH licensure. Will accept any suitable combination of education, training, or experience.
Position requires advanced knowledge of dental terminology and dental procedures and the ability to read and interpret radiographs, electronic images and photos; experience working with word processing and spreadsheet software; effective verbal and written communication skills; ability to resolve complex problems and use independent judgment; experience with provider system; client contracts and Roosevelt is preferred.
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.
About Delta Dental of Michigan
Sourced by ZipRecruiter
Industry
Insurance services
Company size
501 - 1,000 Employees
Headquarters location
Okemos, MI, US
Year founded
1957