Special Investigations Unit Coder, MI - Remote

Karmanos Cancer Institute; Flint (MI); Remote; USD 50,000 - 70,000; Full time

Job summary

McLaren Health Care seeks a Special Investigations Unit Coder to support medical claims and records reviews remotely. This role ensures coding compliance and collaborates with auditors to drive payment integrity initiatives. The successful candidate will have relevant coding experience and necessary certifications, fostering quality service in a dynamic, high-performance environment.

Qualifications

• Associate's Degree in Health Information Management or equivalent experience.
• Certified Medical Coder certification required.
• At least two years of experience in coding.

Responsibilities

• Perform medical claims and records reviews to assist investigations.
• Ensure coding compliance and collaborate with SIU auditors.
• Drive efforts in payment integrity and provider education.

Skills

ICD-10-CM coding

AMA diagnostic coding

Coding compliance

Program integrity guidelines

Education

Associate's Degree in Health Information Management

High School Diploma with two years of relevant experience

Certified Medical Coder (CPC, RHIT, or RHIA)

Job description

Special Investigations Unit Coder, MI - Remote

Join to apply for the Special Investigations Unit Coder, MI - Remote role at McLaren Health Care.

We are seeking a SIU Coder to join our organization and lead our efforts in medical claims review and investigations.

McLaren Integrated HMO Group (MIG), a subsidiary of McLaren Health Care Corporation, operates McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. We foster a high-performance culture with a mission to promote healthier, more satisfying lives.

Our subsidiaries value talent and abilities, promoting an open, cooperative, and dynamic environment where employees and health plans thrive. As part of MIG, you will be a leader driving organizational success and delivering quality service to our members.

McLaren Health Plan serves Michigan members, and MDwise serves Indiana, working with state agencies and CMS on various health insurance programs. Learn more at McLaren Health Plan and MDwise.

Position Overview: The SIU Coder supports McLaren’s lines of business by performing medical claims and records reviews to assist investigations, ensuring coding compliance, and collaborating with SIU auditors and other departments on payment integrity and provider education.

This position is fully remote.

Qualifications:

• Associate's Degree in Health Information Management, Healthcare Business Services, or related field, or a high school diploma with two years of relevant experience.
• Certified Medical Coder (CPC, RHIT, or RHIA).
• At least two years of experience in ICD-10-CM and AMA diagnostic coding, with knowledge of program integrity coding and guidelines.
• Experience coding across multiple specialties.

Preferred Qualifications:

• Five years of coding and billing experience.
• Experience assisting with SIU audits.
• Managed Care experience.

Additional Information:

• Schedule: Full-time
• Requisition ID: 25003753
• Work hours: 8:30 am - 5:00 pm
• Hours per pay period: 80
• On Call: No
• Weekends: No

Seniority Level

Mid-Senior level

Employment Type

Full-time

Job Function

Engineering and Information Technology

Industries

Hospitals and Healthcare

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