Coder II

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

Job summary

McLaren USA in Michigan is seeking a skilled healthcare coder to review inpatient and outpatient records and assign ICD-10-CM, CPT-4/HCPCS and ICD-10-PCS codes for diagnoses and procedures. You will determine principal diagnoses, co-morbidities and surgical procedures, ensuring accurate charge capture.

Responsibilities include outpatient coding and charge validation across multiple specialties, applying modifiers, researching NCD/LCD guidelines, and maintaining a 95% accuracy rate while meeting

Qualifications

• Associate's degree in HIT or related field.
• 2 years of Facility Inpatient, Outpatient or Professional Coding experience.
• Certified in one of the following: AHIMA RHIA/RHIT/CCS; AAPC CPC/CCC/COC/CIC/CHONC; AMAC ROCC.

Responsibilities

• Outpatient coding and charge validation (charge entry) in multiple specialties.
• Code review for inpatient and outpatient records (≤30 days and >30 days LOS).
• Assign ICD-10-CM, CPT-4 with charge validation and ICD-10-PCS codes.
• Apply appropriate modifiers and charge entries for E/M, procedures, injections, infusions.
• Validate CPT-4 codes (charges) captured by departments for specific encounters.
• Research NCD/LCD guidelines related to modifiers to ensure clean claims.
• Determine principal diagnosis, co-morbidities and secondary conditions.
• Maintain >=95% accuracy while meeting production standards.

Skills

Medical coding

ICD-10-CM coding

CPT-4 coding

Charge entry

NCD/LCD knowledge

Attention to detail

Quality standards

Education

Associate's degree in HIT / related field

RHIA / RHIT / CCS

CPC / CCC / COC / CIC / CHONC

AMAC ROCC (Radiation Oncology Certified Coder)

Job description

Position Summary:

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:

1. Responsible for outpatient coding and charge validation (charge entry) in multiple specialties
2. Responsible for coding (inclusive of <30 days of LOS and >30 days of LOS)
3. Reviews, identifies and assigns ICD-10-CM, CPT-4 with charge validation and ICD -10-CM/ICD -10-PCS codes
4. Applies (charge entry) appropriate soft codes for evaluation and management level(s), observation hours, injections, infusions, and other procedures as necessary.
5. Validates CPT -4 codes (charges) captured by McLaren departments such as hard-coded charges for services provided on specific encounters.
6. 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.
7. Determines the correct principal diagnosis, co-morbidities and complications, secondary conditions, and surgical procedures.
8. Meets or exceeds the established quality standard of 95% accuracy rate while meeting or exceeding production standards.

Qualifications:

Required:

• 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.