McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, 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.

Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

Position Overview: 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.

Qualifications:

Required:

Associate’s degree in Health Information Management, Healthcare Business Services, or equivalent program with emphasis in coding or High School diploma with two (2) years of related experience.
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 (2) years’ experience in Medicare Risk Adjustment (MRA) HCC coding documentation guidelines, rules and regulations or the ACA equivalent.

Preferred:

Five (5) years’ HCC coding and/or coding and billing experience.
Two (2) years’ experience in Medicare Programs.
Three (3) years’ experience in managed care.

Learn more about this Employer on their Career Site