About Us
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 centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.
Coder III
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% 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
Equal Opportunity Employer
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.
