• RN Medical Claim Review Nurse Remote

    Molina Healthcare (Detroit, MI)
    …experience including diagnosis. Candidates with knowledge of CPT/HCPCS codes, record review, chart audit , provider disputes, appeals, and 1500 & UB04 claim ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....clinical experience. * Facilitates document management, clinical reviews, bill audit findings and audit details in the… more
    Molina Healthcare (10/19/25)
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  • Clinical Quality Nurse Specialist

    Hospice of Michigan (Kalamazoo, MI)
    …support of the mission of NorthStar Care Community. The Clinical Quality Nurse Specialist is responsible, through monitoring and supporting clinical staff, for ... policies and procedures, and compliance to regulatory requirements. + Conducts patient chart audits to assess clinician's ability to document timely, accurately and… more
    Hospice of Michigan (08/09/25)
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  • Revenue Integrity - Nurse Auditor

    Trinity Health (Ann Arbor, MI)
    …optimization. Investigates denials and root causes, which includes performing thorough chart reviews, providing education to clinical colleagues, and tracking of ... between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / Licensed Practical … more
    Trinity Health (10/10/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Dearborn, MI)
    …make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical ... audit activities. + Draws on advanced ICD-10 coding expertise,...recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a minimum… more
    Elevance Health (10/22/25)
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  • Patient Care Technician - PCT - Dialysis Preceptor

    Fresenius Medical Center (Albion, MI)
    …and training for patients under the direct supervision of a licensed nurse under organization policies, procedures, and training and in compliance with regulations ... under the direct supervision of the Home Therapies registered nurse (HT RN), in compliance with, and as permissible...+ Participates in medical records, infection control, and other audit processes as directed. + Actively collaborates with others… more
    Fresenius Medical Center (10/17/25)
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  • OB/GYN

    Grace Health (Battle Creek, MI)
    …Provides medical consults for and collaborates in patient care with advanced nurse practitioners and certified nurse midwives, as indicated. TYPICAL PHYSICAL ... Creek Hospital within the scope of their specialty. 4. Responsible to review audit findings, provide in-service training, review changes in service and implement new… more
    Grace Health (08/07/25)
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