- 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
- Humana (Lansing, MI)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Elevance Health (Dearborn, MI)
- **DRG CODING AUDITOR ** **Location** : _This position will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR ** is responsible for ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines… more
- Highmark Health (Lansing, MI)
- …Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… 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
- State of Michigan (Lansing, MI)
- …for the invoicing and proper recording of MDOT receivables and damage claims , oversees certain annual financial reporting requirements, is responsible for the ... and managerial reports equivalent to an Accountant or an Auditor , including two years equivalent to an Accountant P11...including two years equivalent to an Accountant P11 or Auditor P11, or one year equivalent to an Accountant… 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