- 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)
- …medical claims review, claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. ... necessity and appropriate/accurate billing and claims processing. * Validates member medical records and claims submitted/correct coding to ensure appropriate… more
- Molina Healthcare (Sterling Heights, MI)
- …Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge and experience, responsible ... appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record… more
- Trinity Health (Livonia, MI)
- …Guidelines for Coding and Reporting + The American Hospital Association (AHA) Coding Clinic + The American Medical Association (AMA) for CPT codes and ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Analyzes physician/ provider documentation contained in assigned Emergency Department (ED) and… more
- Trinity Health (Livonia, MI)
- …program standards, policies, procedures and workflows. Assists with policy and education development on the use of guidelines and proper documentation requirements ... and participates in performance improvement initiatives. Provides training and education to clinical documentation specialists (CDS) to enhance clinical and… more
- Trinity Health (Livonia, MI)
- …quality. Works closely with Regional and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials ... processes to improve performance and achieve defined goals. Provides training and education to clinical documentation specialists (CDS) to enhance clinical and … 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)
- …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
- Fresenius Medical Center (Madison Heights, MI)
- …are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, ... and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific… more
- WTW (Southfield, MI)
- …retirement business and technology. The ideal candidate will have hands-on experience coding systems and a deep understanding of market technology. This role is ... and resolved. You will work with other product workstream coordinators to provide technical guidance and bridge the gap between business knowledge and technical… 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
- 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
- Pearle Vision (Royal Oak, MI)
- …appointments * Processing insurance claim forms * Patient and insurance billing * Optometric medical billing and coding * Vision insurance billing and coding ... the discretion of senior management. JOB TITLE: Optometric Office Technician / Medical Office Administrator REPORTS TO: Store General Manager FLSA STATUS: Hourly;… 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
- 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