Temp - Administrative - Claims Coder (Days) Flint MI
Temp - Administrative - Claims Coder (Days) Flint MI
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Job Description
Position Summary:
At the direction of the assigned leadership interprets business rules federal and state guidelines and
prepares specifications for all information systems including benefiting and pricing requirements for claims
processing. Develops and maintains reporting as needed by leadership and operational objectives. Assists
in the enforcement of product reporting and service controls and standards deadlines and schedules by
creating and maintaining detailed development plans. Defines test scenarios involved in testing and
approval of testing results for implementation to ensure business requirements are met. Responsible for
change 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 coding
to 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 and
identify coding errors.
3. Analyzes requirements specifications business processes provider contracts and provides
recommendations for system configuration.
4. Manages and oversees all changes that impact claims configuration to systems including updating
business processes and documentation education to impacted departments and coordinating
changes.
5. Creates detailed development plans to enforce appropriate production reporting and service control
and standards to ensure deadlines are met to meet requirements.
6. Maintains a change control database to document all changes implemented including dates change
description testing approval and evaluation after the change has been implemented.
7. Continually monitors legislation for preventive guidelines and coverage maps HCPCS CPT and
ICD-10 coding to coverage guidelines and ensures system updates are timely and accurate to
standards and publications.
8. Maintains knowledge of current coding guidelines and participates in internal and external quality
review 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 hour
Requirement description :
- 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 TX
All 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 hour
Other 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
Employment Type
Full-time
