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.