Coder IV - (Job Number: 23004457)

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, including review of denials and writing appeal letters. Trains and on-boards outpatient coders. Responsible for coding all inpatient visits: Simple inpatient visits. Complex inpatient visits (inclusive of over 30 days of LOS). Work coding denials and write coding appeals. Attends Clinical Validation Committee meetings, performs assigned encounter reviews for the Clinical Validation Committee. Applies 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 About the company

The McLaren Health Care system includes 15 hospitals, 2 HMO's, ambulatory surgery centers, diagnostics, employed physician network and more.

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