McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, 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 113,000 network providers throughout Michigan, Indiana and Ohio. Position Summary: Responsible for working with and providing ongoing coding and documentation education for physicians, coders, ancillary department staff, clinical documentation improvement (CDI), and other allied health professionals to improve documentation of patient care and to appropriately assign codes and/or determine charges to support those services. Essential Functions and Responsibilities: Completes quality assurance audits on inpatient and outpatient coding specialists, onboarding audits and training of newly hired coding specialists, validating the coding specialist is accurately abstracting data into medical record systems, following coding guidelines and directives. Validates Present on Admission (POA) indicators according to guidelines and identifies any missing or inappropriate queries to providers. Uses payment methodology to audit outpatient and/or inpatient facility coding and billing, MS-DRG or APC assignment, and OPPS reimbursement methodology and shares knowledge with colleagues and clinical team members. Senior Auditor will support the Clinical Validation Initiatives with identifying cases for review and resolution, developing guides for the Clinical Validation Guidebook in partnership with CDI for each identified complication or disease during the Clinical Validation Meetings. Serves as an advisor and support to the Auditor. Performs retrospective, random, and focused audits of coding cases to ensure accurate code application and overall coding quality. Performs periodic and ongoing pre-bill compliance audits to ensure accurate code assignment, application of coding guidelines, and compliance with external regulatory and accreditation requirements. Qualifications: AHIMA Certification (such as RHIA, RHIT, CCS) AAPC (such as CPC, CCC, COC, CIC, CHONC, etc.) AMAC Certification such as ROCC (radiation Oncology Certified Coder) 3 years’ experience conducting medical coding audits and quality performance measures. Associate degree in Health Information Technology, Applied Science, Liberal Arts or other related healthcare field (preferred). AAPC Specialty Certification (such as CIRCC, CPMA) (preferred). Additional Information Schedule: Full-time Requisition ID: 26003280 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. #J-18808-Ljbffr