- 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
- Molina Healthcare (Sterling Heights, 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
- CVS Health (Burton, MI)
- …HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding , and Health Risk Assessments (HRAs).** + ... office visits for routine and acute issues.** + **Administer Annual wellness visits and health risk assessments, which require a holistic view of health … more
- CVS Health (Burton, 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 (Sterling Heights, 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 (Howell, MI)
- …and escalates to Patient Access Lead for resolution. Assists in the training and education of colleagues upon hire and ongoing as new systems and processes are ... date of birth, diagnosis, procedure, date, and physician signature to minimize risk to hospital reimbursement. Accurately uses the patient search feature to find… 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 (Warren, 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
- Molina Healthcare (Sterling Heights, 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
- Molina Healthcare (Sterling Heights, 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