• Coding Auditor Educator

    Highmark Health (Lansing, MI)
    …II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and ... systems, missed secondary diagnoses and procedures and ensures compliance with DRG /APC structure and regulatory requirements. Performs periodic claim form reviews to… more
    Highmark Health (08/08/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Dearborn, MI)
    …Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions… more
    Elevance Health (08/09/25)
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  • Coding Liaison

    R1 RCM (Detroit, MI)
    …medical necessity edits + Identify trended coding quality issues requiring new or refresher coder education for accurate and compliant code, DRG /APR- DRG , APC ... assists with coding review inquiries related to ICD-10, CPT, DRG /APR- DRG or APC codes. Our collaborative partners...is required + Minimum of five (5) years of inpatient coding + Minimum of three (3) years of… more
    R1 RCM (08/08/25)
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  • Clinical Documentation Specialist (Remote)

    Trinity Health (Livonia, MI)
    … Care Nursing, as an RN, related field, or as an inpatient coder preferred. Excellent communication (verbal and written), interpersonal, collaboration ... compliant working diagnoses codes, establishing a working principle diagnosis and working DRG (MS or APR). Collaborates with coding staff to ensure documentation of… more
    Trinity Health (07/25/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …reports quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review, Appropriate Level of Care, Inpatient ... and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case Manager ,… more
    Molina Healthcare (08/08/25)
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