What are the responsibilities and job description for the Coder IV position at McLaren Health Care Corp?
About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan, Indiana and Ohio. The McLaren system includes 14 hospitals in Michigan and Ohio, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, 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, one of only 51 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Coder IV
Michigan, Grand Blanc
NEW
Technical
McLaren Health Care Corp
23007519
Position Summary:
Responsible for coding all simple and complex hospital inpatient stays (Inpatient Coder IV) or all outpatient patient type records (Outpatient Coder IV) reviews documentation and properly identifies and assigns ICD-10-CM, CPT/HCPCS and/or 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:
- Outpatient Coder IV will be responsible for coding and charge validation (charge entry) of all patient types:
- Resolves CCI/NCCI Edits and Denials, inclusive of review and resolution of pre-bill and post-bill edits, inclusive of review of denials and writing appeal letters.
- Trains and on-boards outpatient coders.
- Responsible for coding all inpatient visits:
- Simple inpatient visits (with < 30 days of LOS).
- Complex inpatient visits (inclusive of < 30 days of LOS and >30 days of LOS).
- Work coding denials and write coding appeals.
- Attends Clinical Validation Committee meetings, preforms assigned encounter reviews for the Clinical Validation Committee.
- Applies (charge enter) appropriate soft codes for evaluation and management level(s), observation hours, injections, infusions, and other procedures as necessary.
- Validates CPT codes (charges) captured by McLaren departments such as hard-coded charges for services provided on specific encounters.
- Abstracts required data per facility specifications.
- Performs medical necessity for Medicare and other payers as required per payment guidelines.
- 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.
- Reviews daily/weekly system-generated error reports to correct or complete missing data elements.
Qualifications:
Required:
- Associates degree in HIT or closely related field
- Minimum five years of Facility Inpatient or Outpatient Coding experience.
- RHIT (Registered Health Information Technician (AHIMA) or CCS (Certified
Coding Specialist (AHIMA) certification
Equal Opportunity Employer of Minorities/Females/Disabled/Veteran
Additional Information
- Schedule: Full-time
- Requisition ID: 23007519
- Daily Work Times: Standard Business Hours
- Hours Per Pay Period: 80
- On Call: No
- Weekends: 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.
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