• Facility Coding Inpatient DRG Quality

    Banner Health (MI)
    …you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and ... - 3 months according to individual needs, with continued support throughout your career here! This is a fully...reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to… more
    Banner Health (06/15/25)
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  • Principal Compliance Investigator | Full Time

    Henry Ford Health System (Detroit, MI)
    …coding practices; prepares reports of findings and meets with providers and medical office staff to provide education and training on accurate coding practices ... recommendations as needed for compliance. + Partner with and provide oversight and support to a variety of partners organizationally across HFH to conduct internal… more
    Henry Ford Health System (07/29/25)
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  • Special Investigation Unit Analyst

    Corewell Health (Grand Rapids, MI)
    …may include research, interviews, data analysis, and substantive desk or onsite medical record review. Responsible for preparing case file, final report and ensuring ... data to detect fraudulent or abusive practices by utilizing system tools, interviews, medical records audits, data mining, perform compliance audits of medical more
    Corewell Health (08/08/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure ... 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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  • Sr Analyst, Scope Management - Healthcare

    Evolent (Lansing, MI)
    …data shifts, and translate insights into actionable strategies. + Provide analytical support and generate reports for client implementations, ad hoc projects, and ... coding maintenance updates. + Apply expertise in healthcare coding to support prior authorization and financial scope reconciliations, ensuring accuracy and… more
    Evolent (07/18/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Lansing, MI)
    …Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding ... and mentor a team of CPCs, providing training, guidance, and support in coding practices and medical record reviews. + Conduct regular audits of team performance… more
    CVS Health (08/08/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Sterling Heights, MI)
    …who must be licensed for the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer ... programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support...of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist +… more
    Molina Healthcare (08/02/25)
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  • Coding Data Quality Auditor

    CVS Health (Lansing, MI)
    …all State and Federal regulations and internal policies and procedures. + Utilize medical records to ensure support is documented for etiology and manifestations ... every day. **Position Summary** + Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that… more
    CVS Health (08/09/25)
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  • ProFee Coding QA Mentor/Trainer

    R1 RCM (Detroit, MI)
    …alignment with client needs and specifications. + Researching, escalating, and responding to coder support questions as triaged by leadership. + Mentor new ... sampling of accounts to identify opportunities for education and support to the coding staff + Review audits performed...proficiency in MS Excel & PowerPoint. + Proficiency in medical terminologies and disease processes. + Strong attention to… more
    R1 RCM (08/08/25)
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  • Acute Access NP, Virtual Care

    CenterWell (Lansing, MI)
    …the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
    CenterWell (08/08/25)
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