Description

The Coding Coordinator role provides a flexible, hybrid work option after completion of new hire on-site training. The selected candidate may work from home up to 4 days per week and select a consistent 8-hour work schedule (may start as early as 5:00 AM).

Purpose:
Same responsibilities of Coder II plus works directly with Coding Management regarding Revenue Cycle Processes and issues. Assists in recommendation and implementation of process changes. Acts as a primary resource for questions from other coding staff and assists management with monitoring daily activity and supervision of staff. Reviews/approves adjustments to accounts. Ensures adherence to all applicable SOX coding and reimbursement controls. Provides coding and reimbursement reports to administration to ensure all KPI's are maintained.

Responsibilities:

• Utilize computer applications and resources essential to completing the coding process efficiently.
• Make forward progress within the training period toward meeting coding accuracy standards of the department within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
• Be a resource for other coders.
• 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). Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding.
• May supervise staff, including assignments and Kronos approval and sign off, as well as, assist with recruitment, as the size of the department and business need dictates.
• Adhere to internal and system-wide competencies, behavior 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.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• 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.
• Responsible for assigning the PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation.
• Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to provide education to physician to accurately complete the coding process.

Qualifications

• High school graduate or equivalent.
• Proficient computer skills with MS excel knowledge.
• Five years of experience in Revenue Cycle Processes and Data Analysis, written and oral communication skills are preferred.
• 5 years Coding Experience Required. Revenue Cycle Experience Preferred.

Licensure, Certifications, and Clearances:
Clearances must be dated within 90 days

• Act 34 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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