McLaren Health Care
Location
Flint, Michigan
The Risk Adjustment Coder supports McLaren Health Plan lines of business by reviewing medical records to identify, collect, assess, monitor, and document claims and encounter information related to risk adjustment for Medicare and Commercial/ACA populations. This role requires strong skills in identifying chronic conditions and coding according to industry guidelines to ensure accurate and compliant documentation.
Required qualifications include an Associate’s degree in a relevant field or a High School diploma with two years of related experience, along with a CPC or CRC credential. Candidates must possess two years of hands-on experience in ICD-10-CM diagnostic coding, preferably in Risk Adjustment or HCC coding, and two years of experience with Medicare Risk Adjustment (MRA) HCC coding guidelines or ACA equivalents.
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.
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.
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