34 jobs found in Detroit, MI

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As an Inpatient Coding Auditor & Educator you will conduct comprehensive audits of inpatient medical records to ensure accurate DRG (Diagnosis-Related Group) assignment and compliance with coding guidelines. This role also involves educating clinical and coding staff on DRG-related topics to enhance documentation quality and coding accuracy. To thrive in this role, you must have adult education or training experience, inpatient coding and audit experience and carry an AHIMA or AAPC coding certificate. Here’s what you will experience working as an...

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Hospital Coding Auditor, you will review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes). The Auditor must have a comprehensive understanding of medical terminology, coding, contractual agreements, and various payment methodologies.  This position requires good time management skills and the ability to work independently. Here’s what you will experience working as a Hospital Coding Auditor Review hospital charges against medical record and all...

Description The Clinical Supervisor (RN) will oversee a team of 15-25 remote Medical Review Nurse Analysts that complete Prior Authorization (PA) work for our Medicare contract. The primary purpose of this leadership role is to provide coaching to team members on production of work, quality of their reviews and education delivery to providers. This role contributes to WPS by ensuring that we meet program requirements for the Centers for Medicare & Medicaid Services (CMS) PA program. In this role you will: Monitor team and individual quality and quantity metrics Coach and train team members Ensure proper workload distribution and timely completion Collaborate with other Clinical Supervisors on education planning Salary Range $75,000-90,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. How do I know this opportunity is right for me? If you: Enjoy leading and helping teams grow Are strong at...

GENERAL SUMMARY: Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. PRINCIPLE DUTIES AND RESPONSIBILITIES: * Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient's medical record, including histories, physicals,...

At R1 RCM we are a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. We deliver proven ROI across the entire revenue cycle – front, middle and back office. This enables our customers to achieve an optimal revenue cycle – one that promotes patient satisfaction and improves financial performance. R1 is currently seeking a Physician Coding Auditor with a background in Physician coding, billing, and reimbursement guidelines. The Auditor must understand medical terminology, coding, contractual agreements, and various payment methodologies. This position requires good time management skills and the ability to work independently. Every day in this role, you will: Review physician charges against medical record and all applicable documentation to determine appropriate code assignments for diagnoses and services provided (CPT/HCPCS codes) Understand billing and coding requirements for government and...

Job Description: Work onsite in the office once a week; this could potentially change Responsible for reviewing and researching new code changes that are released by the Coding Authorities (AMA, Client) for system implementation for PPO and HMO Commercial Business.Required Skills: Must be knowledgeable in use of CPT, HCPCS, ICD-10-CM and ICD-10-PCS code books RHIT or RHIA Certification Required Ability to analyze, investigate and organize ideas in defining and formulating solutions Proficient in current industry standard PC applications and systems (e.g. Word, Excel and MS Office) Ability to work independently, within a team environment and handle multiple priorities Must be knowledgeable in use of CPT, HCPCS, ICD-10-CM and ICD-10-PCS code books RHIT or RHIA with specialty certification of CCS, CCS-P preferred Works collaboratively with Physicians and other team members Knowledge of PPO and HMO claim systems and benefits a plus.EEO EmployerLanceSoft is a certified Minority Business...

We are currently looking for individuals to fulfill Part-Time and Full-Time Medical Biller positions. No experience is required to apply for the position. Training is provided through former experienced employees and available to hired applicants. We are looking for individuals able to carry out various tasks. Individuals must be hardworking and task-oriented. Don't Wait! Fill out a Profile Now! MyJobResource is a staffing and recruitment industry job search engine. We specialize in finding the exact company to suit your needs. We help match job seekers to the right jobs in either full-time or temporary positions. Assignments are typically made depending on the ratio of candidates to jobs, skill-set, and experience. The companies we work with pay us for the services we provide to find the right people for their job openings.

Description Essential Functions + Responsible for billing all patient claims in a timely manner + Responsible for financial assessment of patients, calculation of all TDFPS files, charges and billing, Performs QA of information on admissions, collection of deductibles when needed. + Assist in batching of deposits. + Completes all adjustments from TDFPS. + Process daily day-ends for the hospital, assist in the close of the month, preparations and reporting; + Calculates deposits for the hospital and works closely with the CFO. + Performs log requirements for Medicaid patients. + Assists in the documentation of correspondence. + Business auditing of charts to assure proper billing and documentation. + Review claims issues, make corrections as needed, and rebill. Utilize claims clearing house to review and correct claims and to resubmit electronically when available. + Responsible for printing daily billing reports both electronic and paper claims. Monitor...

Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patients medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.EDUCATION/EXPERIENCE REQUIRED:High School Diploma or G.E.D. equivalent required. Some college or additional coursework in Accounting, Business, Healthcare Administration or Medical Record Sciences...

GENERAL SUMMARY: Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. PRINCIPLE DUTIES AND RESPONSIBILITIES: •Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient's medical record, including histories,...

Medical Billing & Coding Specialist Department: Community Health & Research Center Location: Dearborn, MI START YOUR APPLICATION (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req_id=2402723&source=2402723-CJB-0) Job Title: Medical Billing and Coding Specialist Job Status: Full-time Job Summary: Under close supervision, the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided at all clinics. Employee is responsible for submitting claims for reimbursement and coach healthcare providers to achieve optimal reimbursements. Essential Duties and Responsibilities: + Verify the provider-s determination of services provided and patient diagnoses via office and operative notes + Enter charges in the billing system and/or reviews + Maintain complete knowledge and comply with all relevant insurance, CPT coding and diagnosis guidelines, disseminating info to staff and...

Medical Biller - Durable Medical Equipment Hanover, MD Pay From: $26 per hour MUST: The Medical Biller must have experience: Working in a Durable Medical Equipment environment Strong understanding of Medicare, Medicaid, and private insurance billing processes Must be detail-oriented and have strong communication skills Must have the ability to work independently DUTIES: Process and submit DME claims to insurance companies, Medicare, and Medicaid Verify patient insurance coverage and eligibility Review and correct denied or rejected claims Post payments and reconcile billing discrepancies Maintain accurate billing records and documentation Communicate with insurance providers and patients regarding billing inquiries Ensure compliance with all healthcare regulations and billing guidelines Complete full cycle medical billing Ensuring accurate and timely claim submissions, insurance verifications, payment postings, and follow-ups with both insurance providers and patients Quadrant...

Job Description Job Description Certified Home Health Coder & QA Specialist Become a part of the Hope At Home Family! We currently have a position available for a Certified Home Health Coder & QA Specialist. Position Summary: Certified Home Health Coder & QA Specialist is required to have PDGM, Oasis D1 experience, and Kinnser software knowledge. Home Health Coder is responsible for coding using ICD-10 all diagnoses and applicable procedures of skilled service visits. The position is also responsible for reviewing OASIS and abstracting visit data for billing and data collection purposes. Responsibilities: Codes records using ICD-10-CM and coding guidelines. Reviews OASIS. Observes and report unusual patterns in data collection and/or lack of adequate documentation for code assignments. Review documentation and provide ICD-10 coding recommendations based on current coding and Oasis guidelines. Performs other related duties as requested by the Home...

Job Description Job Description Medical Billing Specialist Full Time – 8:30A-4:30P Surgeons Choice Medical Center is a patient centered health care facility and physician owned destination of care focusing on all hand, joint, orthopedic and sports medicine. In 2004, in an ambitious push to bring hospitality back to the hospital, a small group of top Metro-Detroit surgeons decided to create their own surgical hospital; one that provided patients with the best possible care in a small, easy-to-manage environment that truly embraces the best patient experience. We have since become the premier center of choice with 30 surgical beds, 26 rehabilitation beds, and 6 operating rooms. Surgeons Choice Medical Center has an exciting opportunity for a Medical Billing Specialist. An ideal candidate has a passion to serve people to improve their quality of life and empower them on their health journey. Perks for our staff: ● Competitive hourly pay ● NO WEEKENDS,...

Job Description Job Description Medical Coder Full Time – 8:30A-4:30P Surgeons Choice Medical Center is a patient centered health care facility and physician owned destination of care focusing on all hand, joint, orthopedic and sports medicine. In 2004, in an ambitious push to bring hospitality back to the hospital, a small group of top Metro-Detroit surgeons decided to create their own surgical hospital; one that provided patients with the best possible care in a small, easy-to-manage environment that truly embraces the best patient experience. We have since become the premier center of choice with 30 surgical beds, 26 rehabilitation beds, and 6 operating rooms. Surgeons Choice Medical Center has an exciting opportunity for a Medical Coder. An ideal candidate has a passion to serve people to improve their quality of life and empower them on their health journey. Perks for our staff: ● Competitive hourly pay ● NO WEEKENDS, HOLIDAYS OR ON-CALL! ● Health...

Overview: At United Home Health Services, our dedicated team of professionals is committed to our core values of quality, compassion, and community. Affiliated with Garden City Hospital, United Home Health Services is actively seeking new members to join its award-winning team! Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Responsibilities: The Coder Auditor reviews and analyzes documentation present in the medical record for both inpatient...

Employment Type: Full time Shift: Description: to be able to accurately and timely coder Emergency room and observation accounts using correct coding guidelines and rules and regulations. Analyzes physician/provider documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Accesses charge work queues and systems to assign ER and Observation charges if performed by HIM. May also require calculation of Observation hours if performed by HIM. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of Internal Classification of Diseases, Clinical Modification diagnosis and procedure codes, and Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers. Utilizes coding...

Employment Type:Full timeShift:Description:Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments.Assigns appropriate code(s) by utilizing coding guidelines established by:•The...

Shift: Part Time/24 hrs. per week. Days 8:30AM - 5:00 PM. No weekends. Certified coder for busy multispecialty surgical practice, experience in general surgery or neurosurgery coding preferred. GENERAL SUMMARY: Applies the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities: Abstracts pertinent information from patient records. Assigns the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments. Obtains acceptable productivity/quality rates as defined per coding policy. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintains knowledge of and complies with coding...

Shift: Days 8:30AM - 5:00 PMCertified coder for busy multispecialty surgical practice, experience in general surgery or neurosurgery coding preferred.GENERAL SUMMARY: Applies the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities:Abstracts pertinent information from patient records. Assigns the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments.Obtains acceptable productivity/quality rates as defined per coding policy.Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.Maintains knowledge of and complies with coding guidelines and reimbursement reporting requirements.Conducts...

Job Description Job Description GENERAL SUMMARY: The Billing Follow-Up Specialist is responsible for participating in billing activities that involve the follow-up process for denied claims, coding errors, and other issues. Additionally, the Billing Follow-Up Specialist monitors the department's incoming materials (mail, deliveries, etc.) and seeing to day-to-day tasks of the greater billing department. Under direct supervision the billing specialist performs general departmental job functions, related clerical tasks including opening and sorting mail, scanning, and the organization and mailing of correspondence.   TYPICAL DUTIES AND RESPONSIBLITIES: Reads incoming materials and sorts according to filing and record keeping system. Opens incoming mail and accurately sorts for distribution. Prepares and maintains various schedules to allow for payment posting (receipt posting log, missing EOB log, settlement documents, etc.) Post patient payments in the PM system....

Shift: Days 8:30AM - 5:00 PM Certified coder for busy multispecialty surgical practice, experience in general surgery or neurosurgery coding preferred. GENERAL SUMMARY: Applies the appropriate diagnostic and procedural code to patient health records for purposes of document retrieval, analysis and claim processing. Responsibilities: Abstracts pertinent information from patient records. Assigns the International Classification of Diseases, Clinical Modification (ICD), Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group (DRG) assignments. Obtains acceptable productivity/quality rates as defined per coding policy. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintains knowledge of and complies with coding guidelines and reimbursement reporting requirements....

Join Forbes' 2024 Best Employer for Diversity! As a medical coder on our team, you'll play a vital role ensuring our claims process runs smoothly and efficiently for our customers. Attention to detail is invaluable as you review and enter medical billing information, ensure billing codes correspond with and support medical records, and apply applicable fee schedules and coding rules while making appropriate adjustments. The ideal candidate will have strong customer service and interpersonal skills - which you'll rely on while assisting medical representatives with coding questions and answering calls from customers, providers, billing offices and attorneys. This is a hybrid role. You'll be expected to report to an office about four days per month for important meetings, training, and collaboration and will have the benefit of continued coaching from a supportive team. If you prefer an in-office environment, you're welcome to work in the office more than four days per month....

POSITION DESCRIPTION: Responsible for overseeing the Medical Records and Medical Reception staff and other specified areas of the office in collaboration with office leadership and the Practice Manager. This includes accountability for efficient patient/workflow, customer satisfaction, staff satisfaction, productivity and achievement of operational goals as defined by practice leadership. ESSENTIAL JOB FUNCTIONS: Supervises day-to-day operations of assigned areas to ensure efficient, fiscally responsible and customer-responsive procedures and operations. Serves as a resource to patients and reception office staff; provides direction for the reception team (Receptionists, Medical Records). Is approachable and welcomes opportunity to provide feedback to staff and problem resolution to patients. Develops and distributes daily assignments for assigned Reception staff. Assists with recruitment, hiring, orientation, training and coaching of medical records and medical reception...