McLaren Health Care Configuration Specialist II in Flint, Michigan
Position can be located in Flint, MI or Lansing, MI at McLaren Health Plan or in Indianapolis, IN at MDWise Inc.
McLaren Health Plan, a division of McLaren Health Care Corporation, is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Configuration Specialist II to join in leading the organization forward.
McLaren Health Plan (MHP) is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP and its subsidiaries offer multiple product lines, including employer plans, individual and family plans, Medicaid and Medicare plans, to Michigan residents for every stage of life. The plan has earned the prestigious Pinnacle Award every year since 2013 from the Michigan Association of Health Plans and is also accredited by the National Committee for Quality Assurance (NCQA).
With a commitment to diversity and inclusion, a strong focus on improving the health of our members and a vision to provide the highest standards of quality and service, MHP is poised to meet the challenges of tomorrow.
P o s iti on S u m mar y :
Configures, tests, documents and maintains benefit package and reimbursement system configuration. Assists in maintaining a master library of documents including Certificates of Coverage, Benefit Summaries, Summary Plan Descriptions, regulatory filing documents and benefits/reimbursement policy. Prepares and maintains “job aids” for interdepartmental distribution. Participates in regulatory filings.
Q u al i f i c a t i o n s:
R e q ui r e d :
Associates Degree in computer science, or health information related program. A high school diploma and completion of an AHIMA (The American Health Information Management Association) approved coding program may be substituted.
Valid Certified Coding Associate, Certified Coding Specialist, Certified Professional Coder (CPC), Registered Health Information Technician, or Registered Health Information Administrator.
Three (3) years of related coding experience, directly applying codes.
Two (2) years’ experience working on a system implementation team or direct responsibility for system administration and maintenance.
P re f erre d :
Bachelor’s Degree in computer science, health information related program.
Two (2) years, experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
Job: Non-Health Professional
Primary Location: Michigan-Flint-McLaren Health Plan Bldg
Organization McLaren Health Plan
Employee Status Regular
Shift Day Job
Job Type Standard
Req ID: 20008435