• Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Dearborn, MI)
    **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for...Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates working in person… more
    Elevance Health (12/18/25)
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  • Compliance Audit Manager

    Cardinal Health (Lansing, MI)
    …conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position supervises and ... manages compliance audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services. This position… more
    Cardinal Health (11/08/25)
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  • Manager , Fraud and Waste, Special…

    Humana (Lansing, MI)
    …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions… more
    Humana (12/24/25)
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  • Coding Specialist/Full Time/Michigan Residents

    Henry Ford Health System (Troy, MI)
    …applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Certified Specialist accurately abstracts information from ... EDUCATION/EXPERIENCE REQUIRED: + High school diploma or GED equivalent required. + Billing or coding experience preferred. Some college or additional coursework in… more
    Henry Ford Health System (11/15/25)
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  • *Revenue Integrity Specialist(Clinical…

    Henry Ford Health System (Troy, MI)
    GENERAL SUMMARY: Reporting to the Manager , Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with ... risk by upholding compliance standards. Under limited supervision from the Manager , Revenue Integrity or other more senior Revenue Integrity leaders, the… more
    Henry Ford Health System (10/23/25)
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  • Healthcare Clinical Documentation Specialist

    Deloitte (Detroit, MI)
    …Management or Medical coding certification a plus (CRC, CCA, CCS-P, CCS, CPC , CDIP, CCM) + Experience as clinical registered nurse, physician, physician assistant, ... case manager , clinical documentation specialist, utilization review, informatics RN, Quality,...conducting charge capture and coding reviews for compliance with billing and coding regulatory requirements + Experience in program… more
    Deloitte (11/21/25)
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