- Henry Ford Health System (Troy, MI)
- …and Coding ? If your answer is YES, this position could be for you! The Medical Coding Education Coordinator is 95% remote work, with travel as needed ... work directly with providers. About the Role: As our Medical Coding Education Coordinator, you'll...forefront of coordinating, overseeing, and optimizing the flow of provider education and medical record… more
- Henry Ford Health System (Troy, MI)
- …Must have through knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. + Strong ... GENERAL SUMMARY: Under established coding principles and procedures reviews, analyzes, and validates...record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... position uses information from a tip, member benefits, and medical records to document relevant findings of a post...payments. + Review of applicable policies, CPT guidelines, and provider contracts. + Devise clinical summary post review. +… more
- Henry Ford Health System (Troy, MI)
- …with Revenue Integrity staff to identify charge system weakness, recommends changes, provide education , and tracks utilization. Due to its service focus ... with physician, nursing staff, leadership and other HFH personnel. + Knowledge of medical coding (facility and professional), related medical terminology,… more
- Molina Healthcare (Sterling Heights, MI)
- …and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. ... on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Provides support for medical claim and… more
- Molina Healthcare (Sterling Heights, MI)
- …models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management, Network, and ... early signs of trends or other issues related to medical care costs. + Work with clinical, provider...code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding… more
- Molina Healthcare (Sterling Heights, MI)
- … education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment is generally favorable ... requirements of customers as it pertains to contracting (benefit and provider ), network management, credentialing, prior authorizations, fee schedules, and other… more
- Molina Healthcare (Sterling Heights, MI)
- …as required by regulatory and/or contract requirements. + Renders provider education on appropriate practices (eg, coding ) as appropriate based on national ... to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews.… more
- Molina Healthcare (Sterling Heights, MI)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form). * Advanced understanding of key managed ... executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data… more
- Molina Healthcare (Sterling Heights, MI)
- …of relevant education and experience. * Graduate of an accredited medical assistant (MA) program. * Demonstrated understanding of patient care, medical ... JOB DESCRIPTION Job Summary Provides medical assistant support for Care Connections team. Responsible for contacting members following appointments/services rendered… more
- Molina Healthcare (Sterling Heights, MI)
- …Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding certification. + Strong Medical Claims Audit knowledge To ... processing functions to support systems solutions development and maintenance for Medical Claim Audit. This role includes coordination with stakeholders and subject… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Clinical Documentation Specialist (CDS) uses clinical, coding , and Clinical Documentation Integrity (CDI) knowledge and experience to improve ... the quality and integrity of documentation in the medical record. Identifies factors influencing the complexity of a patients diagnosis and treatment plan. Serves as… more
- Henry Ford Health System (Troy, MI)
- …in assessment and development of proposals to improve utilization patterns, reduce medical costs, enhance provider delivery system, and streamline operational ... personal computers. + Experience with medical terminology. + Experience with medical billing code (CPT and ICD-9/10 coding ), preferred. + Experience managing… more
- Molina Healthcare (Sterling Heights, MI)
- …other state specific audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan Risk/Quality leaders to ... supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all… more
- Molina Healthcare (Sterling Heights, MI)
- …of experience in claims processing or operations or equivalent combination of relevant education and experience + Basic knowledge of medical billing and basic ... role plays a pivotal role in ensuring the timely and accurate resolution of provider -submitted claims issues. This role requires a keen understanding of medical … more
- Molina Healthcare (Sterling Heights, MI)
- …research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, actionable financial and even ... on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network… more
- Molina Healthcare (Sterling Heights, MI)
- …research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, actionable financial and even ... on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network… more
- ChenMed (Eastpointe, MI)
- …other related duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: + Knowledge of medical terminology, CPT, HCPCS and ICD coding desired + An understanding ... vendors, arranging transportation, communicating with physicians, clinicians and other medical personnel, and any other entities necessary for successful completion… more
- Prime Healthcare (Port Huron, MI)
- …supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding , project management and more. We provide services to clinically ... 8. Provide support, repairs, and maintenance for all above-mentioned medical equipment used within the Prime Healthcare Management, Inc. facility. 9. Oversee… more
- Molina Healthcare (Sterling Heights, MI)
- …schedule) Looking for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member ... delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Assesses… more