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Full Time Optum Health Coding Risk Adjustment Jobs in Detroit, MI

A strong knowledge of JOINT COMMISSION, MICHIGAN MENTAL HEALTH CODE, CMS standards, and any other ... UNAVAILABLEEmployment Type: FULL_TIME

A strong knowledge of JOINT COMMISSION, MICHIGAN MENTAL HEALTH CODE, CMS standards, and any other ... UNAVAILABLEEmployment Type: FULL_TIME

A strong knowledge of JOINT COMMISSION, MICHIGAN MENTAL HEALTH CODE, CMS standards, and any other ... UNAVAILABLEEmployment Type: FULL_TIME

A strong knowledge of JOINT COMMISSION, MICHIGAN MENTAL HEALTH CODE, CMS standards, and any other ... UNAVAILABLEEmployment Type: FULL_TIME

Analyze trends across multiple teams and recommend strategies for scalability, efficiency, and risk ... Bachelor's degree in Health Information Management, Healthcare Administration, or a related field

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Full Time Optum Health Coding Risk Adjustment information

See Detroit, MI salary details

$15

$26

$37

How much do full time optum health coding risk adjustment jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for full time optum health coding risk adjustment in Detroit, MI is $26.09, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $29.28 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a full time Optum Health coding risk adjustment professional?

To excel in a Full Time Optum Health Coding Risk Adjustment role, you need a solid understanding of medical coding guidelines, risk adjustment models (such as HCC), and typically a certification like CPC or CRC. Proficiency with coding software, electronic health records (EHRs), and risk adjustment analytics platforms is crucial. Attention to detail, analytical thinking, and effective communication help ensure accuracy and collaboration in documentation and reporting. These skills are vital for optimizing compliant coding, improving patient outcomes, and supporting accurate reimbursement in value-based care environments.

What is a full time Optum Health coding risk adjustment?

A Full Time Optum Health Coding Risk Adjustment job involves reviewing medical records and coding data to ensure accurate risk adjustment for health plan members. Employees in this role typically analyze clinical documentation, assign diagnostic codes, and support compliance with regulatory requirements. Their work ensures that health plans receive appropriate reimbursement by capturing the complexity and severity of patient conditions. This role is essential to maintaining data integrity and supporting overall healthcare quality initiatives.

What is the difference between Full Time Optum Health Coding Risk Adjustment vs Full Time Medical Coder?

AspectFull Time Optum Health Coding Risk AdjustmentFull Time Medical Coder
CertificationsCPR, CPC, or CCS often preferredCPR, CPC, or CCS typically required
Work EnvironmentHealthcare insurance, risk adjustment teamsHospitals, clinics, outpatient facilities
Industry UsageHealth insurance, risk managementHealthcare providers, hospitals
Job FocusRisk adjustment coding, data analysisMedical record coding, billing

Full Time Optum Health Coding Risk Adjustment roles focus on risk adjustment coding within health insurance companies, requiring knowledge of risk models and specific certifications. Full Time Medical Coders primarily work in healthcare facilities, concentrating on accurate medical record coding for billing. While both roles involve coding, their environments and focus areas differ significantly.

What are some common challenges faced by full time Optum Health coding risk adjustment professionals, and how can they be addressed?

Professionals in Full Time Optum Health Coding Risk Adjustment roles often encounter challenges such as keeping up with frequent updates to coding guidelines, managing high volumes of complex patient data, and ensuring accuracy under tight deadlines. Staying current with ongoing training, leveraging available coding support resources, and collaborating closely with clinical teams can help address these challenges. Additionally, using advanced coding tools and regularly participating in team meetings can improve both accuracy and workflow efficiency.
What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in Detroit, MI? The most popular types of Optum Health Coding Risk Adjustment jobs in Detroit, MI are:
What are popular job titles related to Full Time Optum Health Coding Risk Adjustment jobs in Detroit, MI? For Full Time Optum Health Coding Risk Adjustment jobs in Detroit, MI, the most frequently searched job titles are:
What job categories do people searching Full Time Optum Health Coding Risk Adjustment jobs in Detroit, MI look for? The top searched job categories for Full Time Optum Health Coding Risk Adjustment jobs in Detroit, MI are:

Clinical Documentation Spec

University of Michigan

Ann Arbor, MI • On-site

$34 - $45.75/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 20 days ago


University Of Michigan rating

8.1

Company rating: 8.1 out of 10

Based on 144 frontline employees who took The Breakroom Quiz

153rd of 614 rated colleges and universities


Job description

Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job Summary
The Clinical Documentation Specialist (CDS) is responsible for applying their knowledge of medical terminology, risk adjustment, and coding to ensure appropriate capture of diagnoses based on coding guidelines and identify gaps and opportunities within ambulatory settings. They are responsible for planning, coordinating, and providing education to faculty, APPs, and house officers related to Hierarchical Condition Categories (HCC). Develop and implement an education plan to communicate the principles and importance of accurate and complete documentation within the electronic health record (EHR). Serve as a resource of documentation guidelines and regulatory requirements and updates. Partner with and maintain strong collaborative relationships with the Medical Director, Physician Champions, UMMG Department Clinical Documentation Specialists (CDS), and Revenue Quality Liaisons (RQL). Understand and articulate data and analysis clinical documentation and risk adjustment coding trends.
Responsibilities*
Core Responsibilities and Expectations:
  • Responsible for outpatient Hierarchical Condition Category (HCC) pre-visit and post-visit reviews and makes corrections when needed to ensure accurate and specific capture of chronic conditions, comorbidities, and risk-adjusting diagnoses based on coding guidelines.
  • Collaborate with providers to clarify and enhance documentation through compliant queries, education, and feedback.
  • Serves as a source of contact and resource for faculty, APPs, and house officers regarding clinical documentation and medical coding for patient care services.
  • Prepare reports to provide feedback on provider performance including HCC documentation and coding. Including specialty specific documentation examples and power point presentations to be shared at department meetings, as requested.
  • Identifies HCC pre-visit and post-visit documentation trends to be shared with the Physician Champion to allow for clinician education.
  • Educate clinicians on risk adjustment models, disease hierarchies, evaluation and management and documentation standards of excellence through one-on-one sessions, tip sheets, new provider onboarding, and group training.
  • Develop tools (ex. Education materials, learning modules, training videos, etc.) which assist providers with efficient, effective documentation and accurate billing.
  • Serves as a resource for documentation requirements and ensures compliance with applicable laws and regulations.
  • Assist with compliance initiatives related to risk adjustment documentation.
  • Partners with the RQL and follow-up to units within Revenue Cycle and ensure consistent communication between all parties.
  • Maintains current with specialty coding updates, work processes, tools, and clinical and administrative applications necessary to perform job functions.
  • Project a professional and positive image when interacting with patients, faculty, and staff.
  • Performs other duties appropriate to the CDS function, as assigned

Department Specific Responsibilities and Expectations:
  • Responsible for outpatient Hierarchical Condition Category (HCC) pre-visit and post-visit reviews and makes corrections when needed to ensure accurate and specific capture of chronic conditions, comorbidities, and risk-adjusting diagnoses based on coding guidelines.
  • Conduct special review requests to assess compliance risk and identify areas of opportunity for improvement in coding and billing practices. Conduct post-review group and individual training and education.
  • Develop and present issue-specific and general revenue cycle presentations to large groups, including faculty meetings, provider orientation sessions, etc.
  • Onboard new faculty and advance practice providers with compliance training via on-line training tools.
  • Research, interpret and communicate applicable laws and regulations, and third-party payer rules.
  • Keep providers informed of rapidly changing regulatory and third-party payer billing rules; serve as a liaison with the clinical departments in the areas of coding and documentation for their specialties.
  • Perform focused analytical documentation and coding reviews to proactively assess compliance and revenue loss risks for areas of concern identified by the Revenue Cycle Compliance and Education office.
  • Participate in management of the Revenue Cycle compliance work plans, including identifying and assessing issues that create risk for the Health System.
  • Collaboration with the Health Information Management (HIM) team on joint projects related to quality measures and best practices in documentation impacting both facility and professional billing.
  • All other duties as assigned.

Supervision:
  • The Revenue Cycle Compliance Provider Educator will be supervised by the Manager of the Provider Education team in the Revenue Cycle Compliance Division
  • The CDS does not have supervisory responsibilities.

Required Qualifications*
  • Associate degree or equivalent
  • At least five years of medical coding experience
  • Current RHIT, RHIA, CPC, CRC, CCDS certification
  • Demonstrated experience providing clinical documentation and coding education to providers.
  • Excellent communication skills (verbal and written) to enable effective outcomes with the diverse complex clinical care teams.
  • Ability to navigate the EHR to identify documents for review to provide accurate capture of clinical information.
  • Extensive CPT and ICD-10 coding knowledge.
  • Medical terminology and clinical knowledge with the ability to review documentation and determine what documentation is needed to provide accurate medical codes.
  • Ability to work independently, self-motivated and ability to adapt to the changing healthcare environment.
  • Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environment.
  • Proficiency in computer use including Microsoft Office Suite experience.
  • Provide support to clinicians on navigating the EHR to make addendums, create SmartTexts and SmartPhrases and utilize templates.
  • Attention to detail with thoroughness and accuracy when accomplishing a task.
  • Possess proactive, strategic, innovative and out-of-the-box thinking.
  • This is a Hybrid/Remote position.

Desired Qualifications*
  • Bachelors degree in health information management or other healthcare related fields.
  • Knowledge of HCC coding and Risk Adjustment Credential from AHIMA or AAPC
  • Demonstrated understanding of Evaluation and Management (E&M), Surgery and Minor procedure coding, billing, and documentation
  • Certification in healthcare compliance through Healthcare Compliance Association (HCCA).
  • Experience performing reviews, analyzing documentation, and identifying areas of risk and potential irregularities across the revenue cycle.
  • Experience interpreting and applying CMS and other third-party payer guidelines and regulations, particularly related to professional services and teaching physician rules.
  • Ability to communicate complex policies and regulations to multiple audiences.

Why Join Michigan Medicine?
Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world?s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.
What Benefits can you Look Forward to?
  • Excellent medical, dental and vision coverage effective on your very first day
  • 2:1 Match on retirement savings

Modes of Work
Positions that are eligible for hybrid work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes here .
Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Application Deadline
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO Statement
The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.
Job Detail
Job Opening ID
277541
Working Title
Clinical Documentation Spec
Job Title
Clinical Documentation Spec
Work Location
Michigan Medicine - Ann Arbor
Ann Arbor, MI
Modes of Work
Mobile/Remote
Full/Part Time
Full-Time
Regular/Temporary
Regular
FLSA Status
Exempt
Organizational Group
Exec Vp Med Affairs
Department
MM Rev Cycle (PTO)
Posting Begin/End Date
7/24/2026 - 8/09/2026
Career Interest
Healthcare Admin & Support

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About University of Michigan

Sourced by ZipRecruiter

The University of Michigan (U-M), based in Ann Arbor, MI, US, is one of America's most esteemed institutions in higher education. Established in 1817, it presides in the industry of education and research, providing a range of services including undergraduate, graduate, and professional education programs. Complementing this is an extensive research activity that has significantly contributed to various fields, from healthcare to engineering, humanities to sports. Upholding its mission "to serve the people of Michigan and the world through preeminence in creating, communicating, preserving and applying knowledge, art, and academic values", U-M consistently ranks among the top universities globally, a testament to its tradition of excellence in learning and research, and a deep commitment to innovation and discovery.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Ann Arbor, MI, US

Year founded

1817

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