- Conduent (Warren, MI)
- …and be part of a culture where individuality is noticed and valued every day. ** Claims Auditor ** **Position is onsite in Warren, MI** Training: Mon- Thur ( On ... audit, processing, accrual and forecasting of supplier obsolescence and cancellation claims in accordance with GM's Standard Terms and Conditions. Primary… more
- Elevance Health (Dearborn, MI)
- **DRG Coding Auditor Principal** _Virtual: This role enables associates to work virtually full-time, providing maximum flexibility and autonomy. This approach ... and skill development. Alternate locations may be considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims… more
- McLaren Health Care (Shelby Township, MI)
- …and efficiency in physician documentation, code assignment, data collection, and claims processing. 3. Performs retrospective, random, and focused audits of coding ... cases to ensure correct coding, legal compliance, and complete charge capture. 4. Evaluates the proper assignment of procedure, modifier, and diagnosis codes to professional services to validate accuracy and compliance. 5. Reports quality results, tracking and… more
- Elevance Health (Dearborn, MI)
- …and audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded ... Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits,… more
- R1 RCM (Detroit, MI)
- …help review and interpret medical records to draft appeals of denied and underpaid claims . Every day you will review medical records to ensure appropriate coding of ... and interpret medical records to appeal denied and underpaid claims . + Apply clinical judgment and knowledge for DRG...a Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters that are well-written, logically… more
- The Diez Group (Dearborn, MI)
- …Enter feed forward information from the steel mills . Process monthly R1 Mill Claims . Monitors status of rejected/hold material in Hold Area and tracks disposition: ... skills with the ability to effectively handle multiple tasks at one time . Auditor Training a plus . Use of measuring equipment (calipers, micrometers, etc.) .… more