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Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Coder II, Profee (ENT Reimbursement)

  • Job ID: 695632674
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc Coding
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $17.92 to $28.44 / hour

Description

UPMC is hiring a Coder II Profee to join our Corporate Team!  This role will work in our Revenue Cycle department during daylight hours, Monday through Friday.  The position will be fully remote!

The Coder II Profee has the same responsibilities as a Coder I.  The role will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, determine level of acuity, procudure(s) performed, billable supplies and diagnosis to substantiate medical necessity.  The Coder II will review and sequence all codes to to maximize reimbursement and address any potential bundling issues.  As well as applying modifiers as needed. LMRP/CCI edit and coding denial resolution.

Do you have prior ENT Coding experience?  If so, this could be the next step in your coding career.  Apply today!


Responsibilities:

 

  • Utilize computer applications and resources essential to completing the coding process efficiently.
  • Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.
  • Refer problem accounts to appropriate coding or management personnel for resolution.
  • 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.
  • Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.
  • Make forward progress within the period toward meeting coding accuracy standards of the departments within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
  • Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD and CPT codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc) and to determine the level of acuity. Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
  • Adhere to internal department and system-wide competencies, behaviors, 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 reviewing updated CPT assistant guidelines and updated coding clinics.
  • 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.

 

Qualifications

  • High school graduate or equivalent.
  • Graduate of an approved certified coding program preferred.
  • In lieu of two years of coding experience with schooling, a minimum of three years experience or CPC certification required.
  • Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM and CPT Coding Guidelines and Procedures.
  • Proficient computer skills with MS excel knowledge preferred.



Licensure, Certifications, and Clearances:

  • Eligible for CPC or CPC specialty certification.



UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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