Coder II

Mclaren-Health-Care; Grand Blanc (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

McLaren Health Care Corporation in Michigan is seeking a coder responsible for inpatient and outpatient records review, assigning ICD-10-CM, CPT-4/HCPCS and ICD-10-PCS codes for diagnoses and procedures.

Essential duties include outpatient coding and charge validation, applying correct modifiers, researching NCD/LCD guidelines, and achieving quality and production targets.

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.
• Certification in AHIMA (RHIA/RHIT/CCS) or AAPC (CPC/CCC/COC/CHONC etc.) or AMAC (ROCC).
• Preferred: 3 years of Facility Inpatient, Outpatient or Professional Coding experience.

Responsibilities

• Responsible for outpatient coding and charge validation (charge entry) in multiple specialties.
• Responsible for coding (incl. < 30 days of LOS and >30 days of LOS).
• Review, identify and assign ICD-10-CM, CPT-4 with charge validation and ICD-10-CM/ICD-10-PCS codes.
• Apply correct modifiers for E/M, observation hours, injections and other procedures.
• Validate CPT (charges) captured by departments and adjust hard-coded charges.
• Research NCD/LCD guidelines to ensure clean claim submissions.
• Determine principal diagnosis, co-morbidities and complications, secondary conditions, and procedures.
• Meet or exceed 95% accuracy while meeting production standards.

Skills

ICD-10-CM coding

CPT-4 coding

Charge validation

Quality focus

Education

Associate’s degree in HIT or related field

RHIA/RHIT/CCS (AHIMA)

CPC/CCC/COC/CHONC (AAPC/AMAC)

ROCC (Radiation Oncology Certified Coder)

Job description

The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network, and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer center. McLaren has 20,000 full-, part-time and contracted employees and more than 93,000 network providers throughout Michigan.

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.

• 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.

Additional Information

• Schedule: Full-time
• Requisition ID: 26012297
• Daily Work Times: 8am - 4:30pm
• On Call: No

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status,national origin, disability, genetic information, height or weight, protected veteran or other classificationprotected by law.