- R1 RCM (Detroit, MI)
- …related to HACs, PSI, Mortalities, Core Measures and focused CMS initiatives + Provides coding education /guidelines to Quality and Risk , related to HAC, PSI, ... DRG/APR-DRG or APC codes. Our collaborative partners include the following R1 teams: Coding , Quality, Education and Training Teams, Revenue Integrity, CDM and… more
- Henry Ford Health System (Detroit, MI)
- Henry Ford Health is seeking an innovative leader for the role of Vice President - Revenue Cycle. In this pivotal position, you will work in collaboration with the ... in delivering world-class results that align with Henry Ford Health 's mission of advancing health and transforming...position will be responsible for overseeing all HIM and Coding functions for the enterprise. This leader will work… more
- Trinity Health (Livonia, MI)
- …to assign ICD codes, MS-DRG, APR DRGs, POA, SOI & ROM indicators Reviews Inpatient health record documentation, as part of the coding process, to assess the ... coding and/or EMR workflow issues that can impact coding . 13. Exhibits awareness of health record...education and experience is required. Bachelor's degree in Health Information Management (HIM) or related healthcare field is… more
- Henry Ford Health System (Detroit, MI)
- …/EXPERIENCE REQUIRED: . Associate degree in liberal arts, business, analytics, information technology, health care related field or medical coding . OR . High ... health care business operations (eg, payer relations, admissions, billing/ coding , authorization etc.), analytics, information technology, health care related… more
- Elevance Health (Dearborn, MI)
- …benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a ... live within 50 miles of one of our Elevance Health PulsePoint locations Carelon Payment Integrity is a proud...for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will… more
- Molina Healthcare (Detroit, MI)
- …is identified as required by regulatory and/or contract requirements. + Renders provider education on appropriate practices (eg, coding ) as appropriate based on ... reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. Duties include performing...and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible… more
- R1 RCM (Detroit, MI)
- …revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1(R) is ... To thrive in this role you must have a coding certification and experience working in revenue cycle. **Key...opportunities for revenue improvement or areas of potential compliance risk . Charge Capture Analysis: + Review and analyze patient… more
- CVS Health (Detroit, MI)
- …HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding , and Health Risk Assessments (HRAs). + ... Conduct office visits for routine and acute issues. + Administer Annual wellness visits and health risk assessments, which require a holistic view of health … more
- Molina Healthcare (Detroit, MI)
- …The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to ... revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends.… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** Trinity Health at Home is seeking an experienced RN remote Clinical Quality Review Specialist with ICD10 ... is Required. OASIS COS-C certification required within 6 months of hire **Trinity Health at Home is seeking an experienced RN Clinical Quality Review Specialist for… more
- Molina Healthcare (Detroit, MI)
- …assessed, and completed for overall team performance. **JOB QUALIFICATIONS** **Required Education ** Bachelor's Degree in Public Health , Business, Finance or ... performance of existing programs and contracts, and ensures alignment with local health plan budgets and forecasts. Accountable for designing and implementing a… more
- Indeed (Detroit, MI)
- …for a wide variety of software projects + Executing Manual and Automated Secure Coding Reviews, primarily in Java, Python and Javascript + Assist in development of ... development teams + Work closely with software developers to advise on secure coding practices and to establish a proactive security posture. + Partnering with… more
- Molina Healthcare (Detroit, MI)
- …contracts, capitation and various forms of risk , ASO, etc. **PREFERRED EDUCATION ** : Master's Degree in Health or Business related field **PREFERRED ... and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network… more
- R1 RCM (Detroit, MI)
- …solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines ... collaboration across various departments. Every day you will conduct risk assessments and feasibility studies, act as a liaison...healthcare provider role (eg, VP at BPO, HCIT, or health system). + Proficiency in Excel, including V-Lookups and… more
- Molina Healthcare (Detroit, MI)
- …Summary** Acts as liaison between Special Investigations Unit (SIU) operations and health plans and internal functional teams to assure a smooth workflow exists, ... learning * Other duties as identified and assigned. **Job Qualifications** **Required Education ** * Bachelor's degree in a related field. **Required Experience** *… more
- GE Aerospace (Detroit, MI)
- …for designing, developing, and testing embedded software within the Integrated Vehicle Health Management (IVHM) team. IVHM creates solutions that perform health ... Additionally, at least 1 year of experience in C coding is required. + **Citizenship Requirement** : Due to...project management, encompassing cost, schedule, earned value, scope, and risk management, is desired. This skill set is crucial… more
- Sedgwick (Detroit, MI)
- …client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. ... Supports the organization's quality program(s). + Travels as required. **QUALIFICATION** ** Education & Licensing** Bachelor's degree from an accredited college or… more