- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Hospital Coding Auditor , you will review hospital charges against medical ... work independently. **Here's what you will experience working as a Hospital Coding Auditor ** + Review hospital charges against medical record and all applicable… more
- Elevance Health (Dearborn, MI)
- **DRG CODING AUDITOR ** **Location** : _This position will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR ** is ... clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding … more
- R1 RCM (Detroit, MI)
- …patient satisfaction and improves financial performance. R1 is currently seeking a Physician Coding Auditor with a background in Physician coding , billing, ... guidelines. The Auditor must understand medical terminology, coding , contractual agreements, and various payment methodologies. This position requires… more
- Highmark Health (Lansing, MI)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... and accuracy of coding , billing and documentation related to DRGs, APCs, CPTs...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
- Cognizant (Lansing, MI)
- …**Experience:** Minimum 5 years of related experience (facility-based auditing and coding experience). **Travel:** None required **About the role:** As an ICD-10 ... the accuracy, compliance, and quality of ICD-10-CM and ICD-10-PCS coding for inpatient records. You will be a valued...and team. **In this role, you will:** - **Ensure Coding Accuracy and Compliance** . Conduct thorough reviews of… more
- Ascension Health (Kalamazoo, MI)
- …Perform periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. + Audit specified number ... of records per coder as defined in the system coding audit plan. + Prepare audit reports that are...+ Develop corrective action plans to address opportunities for coding , billing and documentation improvement. + Identify trends and… more
- Humana (Lansing, MI)
- …This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement,… more
- LifePoint Health (Marquette, MI)
- …more Position Summary: Monitors, consults, educates, audits and performs trend coding decision making. Reports to: Director FLSA: Exempt ESSENTIAL FUNCTIONS: ... to all new providers. Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of maximum revenue.… more
- R1 RCM (Detroit, MI)
- …one that promotes patient satisfaction and improves financial performance. As our DRGV Auditor II, your primary role will be auditing inpatient cases for DRG ... accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. **Every...review findings, such as the ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding… more
- Trinity Health (Ann Arbor, MI)
- …is required. Working knowledge of medical terminology, and medical record coding experience (ICD-9, CPT, HCPCS) are highly desirable. Customer service background ... is required. Working knowledge of Electronic Health Records (EHR) is preferred. Ability to interact effectively with multidisciplinary teams, including physicians and other clinical professionals internally and externally. Must possess in-depth familiarity… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical ... day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes....a Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters that are well-written, logically… more
- Corewell Health (Grand Rapids, MI)
- …of services billed, including medical necessity, and compliance with other documentation, coding and billing standards. + Creates clear and accurate audit findings ... Health care operations, auditing and or compliance + Compliance auditor , nurse auditor , or other audit function...+ ICD 9 or ICD 10 and CPT 4 coding or medical record audit and review + CRT… more
- R1 RCM (Detroit, MI)
- …client implementations via data validation and Rule Engine preparation. + Create Auditor Education meeting content based on QA findings and provide educational ... materials cross-functionally. **Required Skills:** + Experience with hospital/physician coding . + Medical Coding Certification - CCS, CPC, CPC-H - preferred. +… more
- State of Michigan (Lansing, MI)
- …monitoring and correcting revenue and expenditure activity, establishing account coding and reporting systems, and providing technical information to program ... including one year equivalent to a Financial Analyst P11, Accountant P11, or Auditor P11. Alternate Education and Experience College credits may be substituted on a… more
- Elevance Health (Dearborn, MI)
- …audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded accurately ... test claims, analyzing results, identifying and resolving client intent or benefit coding issues, proposing solutions and directing the implementation of changes. +… more