Job Description

Job Title: Coder III - Technical
Job ID: 660934
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift:
Facility:
Department: Rev Cyc Coding
Location: 2 Hot Metal Street, Pittsburgh PA 15203

Description

Purpose:
Are you looking to grow in your coding career?  UPMC is searching for a Coder III to join their team!  This position will include all of the responsibilities of a coder trainee, coder I, and coder II.  The Coder III monitors and responds to accounts on Pre-Bill edit and error reports.   They will assist with training other coders as requested. The Coder II performs PHC4 coding corrections and provides feedback to coders who made errors.   This role monitors the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion time frame.  The Coder II reviews and responds to the Pre-Bill Edit report issues to ensure timely billing and assists with special projects as requested.

Responsibilities:
  • Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in monthly coding meetings and share ideas and suggestions for operational improvements. Maintain continuing education by attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics.
  • Code all diagnoses and procedures by assigning and verifying the proper ICD-9-CM and CPT codes (DSM IV if applicable). Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding.
  • Complete work assignments in a timely manner and understand the workflow of the department. Maintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks.
  • Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients.
  • Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process.
  • Make forward progress within the training period toward meeting coding accuracy standards of 98% within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
  • Refer problem accounts to appropriate coding or management personnel for resolution.
  • Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-9-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
  • Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories. If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database. Correct any data to be in error after reviewing the medical record and comparing with system entries.

Qualifications

  • High School or GED equivalent. 
  • Completed an AHIMA or AAPC-certified coding program, Bidwell Training School or equivalent program. 
  • Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures. 
  • Three years hospital coding experience.

Licensure, Certifications, and Clearances:
Requires Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $16.61 to $27.60

Union Position: No

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