…Credentialing Specialist, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an

…of services as it relates to Quality Management programs. Oversight of HMO referrals pre-certification and retroactive reviews, delegation oversight with contracted

…to appropriate offices and agencies. + Collects cash payment from patients ( HMO co-pays, deposit is required for products and services). + Performs cashiering

…documentation of resident evaluations, treatment plans, daily and progress notes, HMO /Manage care progress updates in EMRs( Net Health/PCC). . Education: Educate

…customer service experience. + Knowledge of Medicare, Medicaid, and other commercial payers ( HMO , PPO) preferred. + Associate or bachelor degree may be accepted in

…knowledge of ASC Allowable procedures. + Handles contracted and non-contracted; HMO , PPO, EPO, POS, Worker's Com., self-pay and third-party reimbursement issues.

…and their families through Delta Dental Insurance Company, two PPOs and one dental HMO plan. Both PPO plans allow employees to choose any licensed dentist. Vision -

…a pharmacy tech in a retail or community pharmacy setting, health plan, HMO and/or PBM setting. Prior experience performing tasks related to medication therapy

…Nursing Home Leadership Team regarding status & deadline of concurrent review - Managing HMO 's. REQUIREMENTS: + 3 - 5 years' experience in a similar role is

…members. Founded in 1993, Prominence Health started as a health maintenance organization ( HMO ) and was acquired by a subsidiary of Universal Health Services, Inc.