Temp - Administrative - Claims Coder (Days) Flint MI

Bestica

  • Flint, MI
  • $26.34 per hour
  • Temporary
  • Full-time
  • 2 days ago
  • Apply easily
Position Summary:At the direction of the assigned leadership, interprets business rules, federal and state guidelines andprepares specifications for all information systems, including benefiting and pricing requirements for claimsprocessing. Develops and maintains reporting as needed by leadership and operational objectives. Assistsin the enforcement of product, reporting and service controls and standards, deadlines, and schedules bycreating and maintaining detailed development plans. Defines test scenarios, involved in testing, andapproval of testing results for implementation to ensure business requirements are met. Responsible forchange management that impact claims configuration for all systems.Essential Functions and Responsibilities:1. Interprets business rules, Federal and State guidelines, including but not limited to outpatient codingto create rules for processing within systems to ensure requirements are met.2. Responsible for auditing medical records against submitted claims to verify accuracy of coding andidentify coding errors.3. Analyzes requirements, specifications, business processes, provider contracts and providesrecommendations for system configuration.4. Manages and oversees all changes that impact claims configuration to systems, including updatingbusiness processes and documentation, education to impacted departments, and coordinatingchanges.5. Creates detailed development plans to enforce appropriate production, reporting and service controland standards to ensure deadlines are met to meet requirements.6. Maintains a change control database to document all changes implemented including dates, changedescription, testing, approval and evaluation after the change has been implemented.7. Continually monitors legislation for preventive guidelines and coverage, maps HCPCS, CPT, andICD-10 coding to coverage guidelines and ensures system updates are timely and accurate tostandards and publications.8. Maintains knowledge of current coding guidelines and participates in internal and external qualityreview meetings, responses, and corrective action development for corporate and outsourced.9. Works collaboratively with appropriate departments such as system configuration, compliance, legal,medical management, etc.10. Other duties as assigned or when necessary to maintain efficient operations of the department and the company as a whole.This is a 52% markup need. Contractors need to make a facility mandated pay rate of $26.34 per hourRequirement description :Required:Associate degree in Health Information Management, Applied Science, Business Administration,Health Care Administration or equivalent program with emphasis on coding; or High schooldiploma 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 Carefunctions.Two (2) years experience in analytic role utilizing systems and data * Understands this is a temp job only - Required
  • 1 year of experience in Claims or Data Entry - Required
  • Please verify full home address - Required
Approved to hire in: AL, FL, GA, IN, IA, KY, MI, MO, NC, OH (not Cincinnati or Toledo), SC, TXAll other states are a no hire.
This is a 52% markup need. Contractors need to make a facility mandated pay rate of $26.34 per hourOther requirements to note while working on this submission:
  • Must disclose if your candidate has ever worked at any McLaren site or affiliate.
  • Do NOT include any Medical or Personal information that could be construed as a reason not to hire. Profiles will be judged on Experience
  • About 50% of these positions will have perm offers after the 13 weeks
ADDITIONAL LICENSE REQUIREMENTS :
Weekend Requirements : None
On Call Requirements : None

Bestica