Coding Specialist
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 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% accuracy rate while meeting and/or exceeding production standards.
Qualifications:
Required:
- 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)
Preferred:
- 5 years of outpatient, professional or inpatient coding experience.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans