McLaren USA

We are looking for a Supervisor, Medical Management Registered Nurse, 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....

Position Summary: Responsible for reviewing outpatient medical records for proper coding assignment. Position Specifications: *Background in laboratory billing with a focus on Pathology *Hybrid/Remote Position Essential Functions and Responsibilities as Assigned: 1. Accurately assigns codes (CPT-4 and HCPCS) to outpatient medical records based on documentation in the medical record. 2. Accurately verifies, modifies, and abstracts patient data to meet the requirements of data integrity and organization specific protocols and requirements. 3. Understands the coding and classification system(s) revision cycle (ICD-10-CM and MSDRG annually) and takes the initiative to understand coding and classification system changes that impact coding, compliance, and reimbursement requirements. 4. Utilizes the multiple electronic and hard copy resources available to assist in understanding and accurately assigning coding and classification codes. 5. Works closely with the providers to...