Coder II

McLaren Medical Group; Grand Blanc (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

McLaren Medical Group is seeking a Coding Specialist to review inpatient or outpatient records and assign ICD-10-CM, CPT-4/HCPCS and ICD-10-PCS codes for diagnoses and procedures. You will determine principal diagnoses, comorbidities, and surgeries while ensuring clean claims.

Responsibilities include outpatient coding, charge validation, applying E/M modifiers, and researching NCD/LCD guidelines to maintain high accuracy and production standards.

Qualifications

• Associate's degree in HIT, Applied Science, Liberal Arts or related field.
• 2 years of facility inpatient, outpatient or professional coding experience.
• Certified in AHIMA RHIA/RHIT/CCS or AAPC CPC/CCC/COC/CIC/CHONC or AMAC ROCC.

Responsibilities

• Outpatient coding and charge validation in multiple specialties.
• Code assignment including ICD-10-CM, CPT-4 with charge validation and ICD-10-PCS.
• Apply E/M level modifiers and document observation hours, injections, and other procedures.
• Validate charges captured by departments for specific encounters.
• Research NCD and LCD guidelines to ensure clean claims.
• Determine principal diagnosis, co-morbidities, complications, and surgical procedures.
• Aim for 95% accuracy while meeting production standards.

Skills

ICD-10-CM coding

CPT-4/HCPCS coding

Charge validation

NCD/LCD knowledge

Quality assurance

Education

Associate's degree in HIT / Applied Science / Liberal Arts

AHIMA RHIA/RHIT/CCS OR AAPC CPC/CCC/COC/CIC/CHONC OR AMAC ROCC certification

Other healthcare related degree

Job description

Coding Specialist

Responsible for coding inpatient or outpatient records review documentation and properly identifies and assigns ICD-10-CM, CPT-4/HCPCS and/or ICD-10-PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, and surgical procedures.

Essential Functions and Responsibilities as Assigned:

• Responsible for outpatient coding and charge validation (charge entry) in multiple specialties
• Responsible for coding (inclusive of < 30 days of LOS and >30 days of LOS)
• Reviews, identifies and assigns ICD-10-CM, CPT-4 with charge validation and ICD -10-CM/ICD -10-PCS codes
• Applies (charge entry) appropriate soft codes for evaluation and management level(s), observation hours, injections, infusions, and other procedures as necessary
• Validates CPT -4 codes (charges) captured by McLaren departments such as hard-coded charges for services provided on specific encounters
• Performs research and investigation regarding National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim
• Determines the correct principal diagnosis, co-morbidities and complications, secondary conditions, and surgical procedures
• Meets and/or exceeds the established quality standard of 95% accuracy rate while meeting and/or exceeding production standards

Qualifications

• Associate's degree in HIT, Applied Science, Liberal Arts or other healthcare related field
• 2 years of Facility Inpatient, Outpatient or Professional Coding experience
• Certified in one of the following:
• AHIMA Certification (such as: RHIA, RHIT, CCS)
• AAPC Certification (such as: CPC, CCC, COC, CIC, CHONC etc.)
• AMAC Certification such as: ROCC (Radiation Oncology Certified Coder)

Preferred

• 3 years of Facility Inpatient, Outpatient or Professional Coding experience