About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, 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, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Coding Auditor Professional
Position Summary: Responsible for working with physicians, coders, ancillary department staff, Clinical Documentation Improvement (CDI), and other allied health professionals to improve documentation of patient care and appropriately assign codes and/or determine charges to support those services.
Essential Functions and Responsibilities As Assigned:
- Responsible for completing quality assurance audits on professional coding specialists, onboarding audits and training of newly hired coding specialists, validating the coding specialist is accurately abstracting data into medical record systems, following coding guidelines, and relevant federal and other pertinent materials.
- Optimizes prospective payment reimbursement and facilitates data quality by creating consistency and efficiency in physician documentation, code assignment, data collection, and claims processing.
- Performs retrospective, random, and focused audits of coding cases to ensure correct coding, legal compliance, and complete charge capture.
- Evaluates the proper assignment of procedure, modifier, and diagnosis codes to professional services to validate accuracy and compliance.
- Reports quality results, tracking and trending of educational opportunities of the coding specialist and provides educational support and training.
- Gathers, transfers, and analyzes all auditing results to capture and demonstrate risk issues, revenue leakage and educational opportunities.
Required:
· Associate degree in HIT, Applied Science, Liberal Arts or related healthcare field
· 1 year evaluation and management (E&M) coding experience in any medical specialty
· 3 years’ experience in surgical and outpatient procedural coding is required.
· Certified in at least one of the following:
- AHIMA Certification (such as: RHIA, RHIT, CCS)
- AAPS Certification (such as: CPC, CCS-P, CCC, COC, CIC, CHONC, etc.)
o AMAC Certification such as ROCC (Radiation Oncology Certified Coder)
Preferred:
· 1 year audit experience
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.
