Offer summary

Qualifications:

Associate’s degree in Health Information Management or equivalent with emphasis in coding., Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) credential required., Two years of hands-on experience in ICD-10-CM diagnostic coding, preferably in Risk Adjustment or HCC coding., Familiarity with Medicare Risk Adjustment (MRA) HCC coding documentation guidelines and regulations is essential..

Key responsabilities:

Review medical records to identify and document claims and encounter information for risk adjustment.

Assess and monitor chronic conditions to ensure accurate coding according to industry guidelines.

Collaborate with internal departments and leadership to support the risk adjustment program.

Ensure compliance with documentation standards for both Medicare and Commercial/Affordable Care Act patient populations.

Job description

We are looking for a Risk Adjustment Coder, to join us in leading our organization forward.

McLaren 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.

McLaren 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.As an employee of MIG, 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.

McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org .

MDwise 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 health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ .

Position Summary:

The Risk Adjustment Coder (RAC) supports lines of business from McLaren Health Plan, Inc. and McLaren Health Plan Community (McLaren) and is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encounter information as it pertains to risk adjustment for both Medicare and Commercial/Affordable Care Act patient populations. The RAC possesses a strong background in reviewing medical records, identifying chronic conditions, and coding according to industry guidelines to ensure accurate and compliant documentation. The RAC works closely with internal departments and leadership to promote activities that support a successful risk adjustment program.

This position is fully remote.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

Qualifications:

Required:

Associate’s degree in Health Information Management, Healthcare Business Services, or equivalent program with emphasis in coding.
Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) credential.
Two (2) years of hands-on experience in ICD-10-CM diagnostic coding, preferably experience in Risk Adjustment or HCC coding.
Two years’ experience in Medicare Risk Adjustment (MRA) HCC coding documentation guidelines, rules and regulations or the ACA equivalent.

Preferred: