About Us

McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.

Risk Adjustment Coder - Remote

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Technical
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McLaren Integrated HMO Group
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25001514 Requisition #

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

#LI-AK1

 

 

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:

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

Equal Opportunity Employer

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

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