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.