- R1 RCM (Detroit, MI)
- …Condition Category) coding and auditing team to ensure accurate and efficient coding of patient diagnoses for risk adjustment purposes. This role involves ... to optimize coding processes. You will perform compliance audits, including risk -based audits and quality review (QR) monitoring, as needed. Every day you will… more
- Henry Ford Health System (Detroit, MI)
- …reports of findings and meets with providers and medical office staff to provide education and training on accurate coding practices and compliance risks. + ... Certified Coding Specialist - Physician Based (CCS- P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT),… 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
- Henry Ford Health System (Troy, MI)
- …proficiency in healthcare/medical economics data and an understanding of healthcare industry coding systems such as ICD-10, CPT/HCPCS, and DRGs. + Take proactive ... for quarterly business meetings. + Perform other related duties as assigned. EDUCATION /EXPERIENCE REQUIRED: + Must have an undergraduate (BS) degree in Statistics,… 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
- Henry Ford Health System (Troy, MI)
- …the patient billing, collection, and payment application processes for Henry Ford Health Corporate Business Office (CBO). This director is responsible for billing ... of all facility and professional services across Henry Ford Health . Henry Ford Health is a multi-facility...planning including, but not limited to, testing, installation and education of staff to produce and maintain high quality… more
- R1 RCM (Detroit, MI)
- …expert and authoritative resource on interpretation and application of CDI practices, coding rules, and regulations and conducts risk assessments of potential ... transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one...the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving… more
- R1 RCM (Detroit, MI)
- …basis, the CDI Specialist is responsible for supporting the direction and focus of education for providers and the coding staff within their assigned scope of ... expert and authoritative resource on interpretation and application of CDI practices, coding rules, and regulations and conduct risk assessments of potential… more
- Henry Ford Health System (Troy, MI)
- …for managing all third-party payer audit processes across the Henry Ford Health System which includes denial, appeal, and financial tracking. This position will ... oversee the following: Coordination and aggregation of the medical, billing and coding records and the timely submission of documentation for Medicare Recovery Audit… more
- Molina Healthcare (Sterling Heights, MI)
- …on databases and ensure adherence to business and system requirements of Health Plans as it pertains to contracting, benefits, prior authorizations, fee schedules, ... Plan for long-term success of the department and individual Health Plans with a focus on goals and improvement...Utilizes superior judgement in evaluating various approaches to limit risk and communicating risk to appropriate stakeholders.… 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
- Molina Healthcare (Sterling Heights, MI)
- …learning * Other duties as identified and assigned. **Job Qualifications** **Required Education ** * Bachelor's degree in a job related field **Required Experience** ... Insurance Fraud and Abuse, Payment Integrity Program, Law Enforcement or Risk Management * Minimum 8-10 years leadership/supervisory experience required *… more