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Claims Coding Specialist, Michigan na McLaren Health Plan

McLaren Health Plan · Flint, Estados Unidos Da América · Remote

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%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3EWe are looking for a Claims Coding Specialist, to join us in leading our organization forward.%3C/span%3E%3C/span%3E%3Cspan style=%22background-color:white;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3EMcLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. It is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.%26nbsp;%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3EMcLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive.%3C/span%3E%3Cspan style=%22line-height:107%;mso-spacerun:yes;%22%3E%26nbsp; %3C/span%3E%3Cspan style=%22line-height:107%;%22%3EAs an employee of MIG,%26nbsp;you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3EMcLaren Health Plan is our Michigan-based%26nbsp;health plan dedicated to meeting the health care needs of each of our Michigan members.%26nbsp; Learn more about McLaren Health Plan at%26nbsp;%3C/span%3E%3C/span%3E%3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22https://www.mclarenhealthplan.org/%22%3E%3Cspan style=%22background-color:white;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3Ehttps://www.mclarenhealthplan.org%3C/span%3E%3C/span%3E%3C/a%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3E.%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3EMDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan%26nbsp;health insurance programs.%26nbsp;%26nbsp;Learn more about MDwise, Inc. at%26nbsp;%3C/span%3E%3C/span%3E%3Ca target=%22_blank%22 rel=%22noopener noreferrer%22 href=%22https://www.mdwise.org/%22%3E%3Cspan style=%22background-color:white;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3Ehttps://www.mdwise.org/%3C/span%3E%3C/span%3E%3C/a%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22line-height:107%;%22%3E.%3C/span%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cstrong%3E%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/b%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cstrong%3EPosition Summary:%3Co:p%3E%3C/o:p%3E%3C/strong%3E%3C/b%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22text-align:justify;%22%3E%3Cspan style=%22color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAt the direction of the assigned leadership, interprets business rules, federal and state guidelines and prepares specifications for all information systems, including benefiting and pricing requirements for claims processing. Develops and maintains reporting as needed by leadership and operational objectives. Assists in the enforcement of product, reporting and service controls and standards, deadlines, and schedules by creating and maintaining detailed development plans. Defines test scenarios, involved in testing, and approval of testing results for implementation to ensure business requirements are met. Responsible for change management that impact claims configuration for all systems.%3C/span%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22text-align:justify;%22%3E%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22text-align:justify;%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3EThis position is fully remote.%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22text-align:justify;%22%3E%3Cspan style=%22color:white;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3E#LI-AK1%3C/strong%3E%3C/span%3E%3Cspan style=%22background-color:white;color:black;font-family:%26quot;Arial%26quot;,sans-serif;font-size:10.0pt;%22%3E%3Cspan style=%22line-height:107%;%22%3E%3Co:p%3E%3C/o:p%3E%3C/span%3E%3C/span%3E%3C/p%3E

Qualifications:

Required:

·        Associate degree in Health Information Management, Applied Science, Business Administration, Health Care Administration or equivalent program with emphasis on coding; or High school diploma with two (2) years of related experience.

·        Certified Medical Coder (CPC, RHIT or RHIA).

·        Two (2) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions.

·        Two (2) years’ experience in analytic role utilizing systems and data.

Preferred:

·        Five (5) years of outpatient, professional or inpatient coding experience.

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