Coder II

McLaren Health Care; Shelby Township (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

McLaren Health Care seeks a skilled medical coder in Shelby Township, MI to review inpatient and outpatient records, assign ICD-10-CM, CPT-4/HCPCS and ICD-10-PCS codes, and determine principal diagnoses and procedures.

The role emphasizes accurate coding, charge validation, and adherence to NCD/LCD guidelines to ensure clean claims. Requires AHIMA/AAPC/AMAC certification and 2 years of coding experience.

Qualifications

• Associate’s degree in HIT or related healthcare field.
• 2 years of Facility Inpatient, Outpatient or Professional Coding experience.
• Certification in AHIMA, AAPC or AMAC (RHIA/RHIT/CCS, CPC/CCC/COC/CIC/CHONC, ROCC) or similar.

Responsibilities

• Code inpatient or outpatient records with ICD-10-CM, CPT-4/HCPCS and ICD-10-PCS.
• Determine principal diagnosis, co-morbidities and procedures.
• Validate charges and apply modifiers per guidelines.
• Research NCDs and LCDs to ensure clean claim submission.
• Maintain quality with 95% accuracy and meet production targets.
• Work across specialties for charge validation and coding accuracy.
• Typical schedule: 8:00 am–4:30 pm, Full-time.

Education

Associate’s degree in HIT

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:

• 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:

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.

Additional Information

• Schedule: Full-time
• Requisition ID: 26004415
• Daily Work Times: 8am - 4:30pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No