- Molina Healthcare (Sterling Heights, MI)
- …(Working Friday, Saturday, Sunday, Monday, and Tuesday) This is a Remote position, home office with internet connectivity of high speed required **Job Summary** ... Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** +… more
- McLaren Health Care (Petoskey, MI)
- …care to home health patients ensuring quality delivery of outcomes based on care that meets the individual needs of the patients/families. Responsible for ... Home Health:** 1. Assists with evaluation of the clinical team and provides on-the-job training in deficient areas....record audits including but not limited to; OASIS, ICD-10 coding , Plans of Care, initial physician orders. 3. Monitors… more
- Evolent (Lansing, MI)
- …who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned with evolving needs. As a member of ... financial scope within Evolent Specialty Services. Reporting to the Director, Clinical Informatics, this role is responsible for acquiring, synthesizing, and… more
- Henry Ford Health System (Detroit, MI)
- …department staff and clinical employees in correct documentation processes and coding guidelines. + Provides instruction based on clinical documentation ... Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS- P), Registered Health… more
- Trinity Health (Livonia, MI)
- …& ROM indicators Reviews Inpatient health record documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support ... guidelines and regulations as well as new applications or settings for Inpatient coding eg, Hospital at Home . 12. Identifies, and attempts to problem… more
- Corewell Health (Grand Rapids, MI)
- …and risk adjustment program changes. Serve as subject matter expert and resource in clinical documentation and coding . Lead and collaborate in the development of ... set by the executive leaders of Risk Adjustment ensuring accurate diagnosis risk coding and achieving related revenue targets.The role is responsible for helping to… more
- Henry Ford Health System (Farmington Hills, MI)
- …multispecialty surgical practice, experience in general surgery or neurosurgery coding preferred. GENERAL SUMMARY: Applies the appropriate diagnostic and procedural ... from patient records. Assigns the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common… more
- Henry Ford Health System (Grand Blanc, MI)
- …conjunction with OP Audit Analysts and Coordinators will utilize documentation and coding expertise to facilitate audits of the quality and completeness of medical ... be responsible for utilizing knowledge of Local, State and Federal coding guidelines and regulations, NCCI Edits, ICD-10CM, CPT, Hierarchical Condition Categories… more
- Henry Ford Health System (Troy, MI)
- …3. Participates in CAB call for Service Now Tickets submitted by Clinical and/or Operational departments. Routes/assigns Service Now tickets to responsible CDM team ... members based on assigned departments. 4. Serves as technical resource...assigned departments. 4. Serves as technical resource for assigned clinical or business departments throughout HFHS. Responsibility includes, but… more
- Humana (Lansing, MI)
- …this knowledge in their daily work. The Medical Director's work includes computer- based review of moderately complex to complex clinical scenarios, review ... these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and… more