• Quality Senior Analyst

    CVS Health (MI)
    …Risk Adjustment Coder ) required. + CPMA (Certified Professional Medical Auditor) **or** CDEO (Certified Documentation Expert Outpatient ) preferred. ... we do it all with heart, each and every day . **Position Summary** Responsible for conducting complex audits, reviews...Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the… more
    CVS Health (09/30/25)
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  • Investigator

    Highmark Health (Lansing, MI)
    …**Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited ... maintain annual anti-fraud program which includes facilitating fraud training and fraud awareness day , as well as filing annual fraud plans and reports according to… more
    Highmark Health (09/10/25)
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  • Compliance Audit Manager

    Cardinal Health (Lansing, MI)
    …of documentation and coding related to physician or hospital (inpatient and outpatient ) billing and/or medical necessity reviews. + Manages focused audits ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
    Cardinal Health (08/27/25)
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