COVID-19 Vaccination Information

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

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   Current UPMC employees must apply in HR Direct

Retrospective Appeals Coder

  • Job ID: 913320775
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Harrisburg
  • Department: Health Infor-Coding-HBG
  • Location: 111 South Front Street, Harrisburg PA 17101
  • Union Position: No
  • Salary Range: $30.55 to $47.34 / hour



The Retrospective Appeal Coder provides support to the local coding departments by initiating the retrospective appeal process for coding denials. Drawing on a coding knowledge base and knowledge of payor regulations, the Retrospective Appeal Coder is responsible for assessing for the presence of criteria to recover denied reimbursement through appeal.


  • Assist in determining system-wide coding needs through investigation of retrospective denials and identification of root cause. Review and resolve pre-bill edits as needed
  • Maintain current knowledge of regulatory guidelines related to retrospective appeals.
  • Serve as a liaison between coding and payors and facilitates payor/physician contact when indicated.
  • Maintain collaborative relationships with coding management and appeal departments at payor organizations.
  • Collaborate with other departments to ensure all information to support retrospective appeal is identified.
  • Formulate written appeal letter as appropriate incorporating supportive documentation. (i.e. medical criteria, state regulations, etc).
  • Perform coding review for cases referred for retrospective appeal/audits to determine if appeal is warranted.
  • Act as liaison to other departments relative to the retrospective appeal process.
  • Provide ongoing education to coding and other departments related to the appeal process.
  • Ensure the appeal process is followed in order to accomplish timely and appropriate appeals.
  • Identify and assign a root cause to each case to ensure denial reasons are tracked.
  • Monitor and evaluate for areas of process improvement related to the retrospective appeal process.


  • Bachelor's degree in Business Administration or related field or Registered Record Administrator (RAA) is preferred.
  • Clinical Document Specialist/Clinical validation of coding experience is preferred
  • 5 years Coding Experience required.
  • Extensive knowledge of DRG/APC, ICD-9/10, CPT/HCPCS classifications and coding of diagnosis and procedures is required.
  • Knowledge of medical terminology, human anatomy/physiology, pharmacology, and pathology is required.
  • Prior appeal/grievance experience preferred.

Licensure, Certifications, and Clearances:

  • Certified Coding Specialist (CCS) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT)
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.

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   Current UPMC employees must apply in HR Direct

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