Coder III

McLaren Health Care • Shelby Township, MI

18h

About The Position

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 and EMRs
2. Responsible for coding inpatient encounters (inclusive of < 30 days of LOS and >30 days of LOS, Rehab, Long-term Acute Care)
3. Reviews, identifies, and assigns ICD-10-CM, CPT-4 with charge validation or ICD-10-CM and 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 and/or exceeds the established quality standard of 95%25 accuracy rate while meeting and/or exceeding production standards.

Requirements

• Associate’s degree HIT, Applied Science, Liberal Arts or other related healthcare field.
• 3 years of facility outpatient, professional or inpatient 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

Nice To Haves

• 5 years of outpatient, professional or inpatient coding experience.

Responsibilities

• Responsible for outpatient coding and charge validation (charge entry) in multiple specialties and EMRs
• Responsible for coding inpatient encounters (inclusive of < 30 days of LOS and >30 days of LOS, Rehab, Long-term Acute Care)
• Reviews, identifies, and assigns ICD-10-CM, CPT-4 with charge validation or ICD-10-CM and 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%25 accuracy rate while meeting and/or exceeding production standards.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree