- 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
- Hospice of Michigan (Kalamazoo, MI)
- …person, every time, 100% of the time. Qualifications: + Bachelor of Science in Nursing preferred. Registered Nurse (RN) licensure in the State of Michigan ... support of the mission of NorthStar Care Community. The Clinical Quality Nurse Specialist is responsible, through monitoring and supporting clinical staff, for… more
- Trinity Health (Ann Arbor, MI)
- … Nurse / Licensed Practical Nurse and graduate of an accredited school of nursing , plus at least four (4) years of nursing experience and two (2) years ... optimization. Investigates denials and root causes, which includes performing thorough chart reviews, providing education to clinical colleagues, and tracking of… more
- Molina Healthcare (Warren, MI)
- …functions. These functions include, but may not be limited to: chart retrieval strategy, risk adjustment retrieval performance, process effectiveness, market ... performance, project build, chart retrieval maximization and risk adjustment compliance. Molina Risk...people management experience * Minimum 5 years Risk adjustment audit /RADV experience * Demonstrated knowledge of and experience with… more
- Molina Healthcare (MI)
- …Adjustment, is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment, RADV, or Risk Adjustment-like projects, and ... other state specific audit projects and deliverables related to accurate billing and...training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data, and chart … more
- University of Michigan (Ann Arbor, MI)
- …by Data Abstractors to maintain and improve data collection activities + Conduct Audit Site Visits or remote auditing at participating sites to evaluate adherence to ... and informative/constructive feedback to sites based on results of Audit Site or Remote Visits + Communicate issues of...position and at least 5 years of experience with chart abstraction, chart review, chart … more
- 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
- 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
- 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