Job Description

Job Title: Certified Coding Specialist II-Profee
Job ID: 746704
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: Rev Cyc Coding
Location: 2 Hot Metal Street, Pittsburgh PA 15203

Description

Purpose:
The Corporate Revenue Cycle has an opening for a Certified Coding Specialist II (CCS II)!  This position has all of the same responsibilities as the Coding Specialist plus working on-site and assisting with staff management. This role will develop new processes and work flows to address issues by analyzing edit/denial data. The CCS II will effectively communicate in a professional manner with staff, other health care professionals, and management team. Thie role acts as liaison for de-central coding departments and works with other departments to develop or enhance automated coding and coding interfaces. This role assists the manager with recruitment and evaluation processes.

This role is based at the Quantum I building and is Monday through Friday during daylight hours.  If it sounds like a fit for you, apply today!

Responsibilities:
  • Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements.
  • Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification.
  • Complete work assignments in a timely manner and adhere to department charge lag goals and understand the workflow of the department.
  • Demonstrate proficiency on billing system functionality, computer applications and resources essential to completing the coding process.
  • Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification and provide education to physicians to accurately complete the coding process.
  • Investigate, resolve and analyze edits and denials and provide reports for process improvement, as necessary.
  • Lead, participate in and/or assist with departmental coding audits.
  • 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.
  • Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
  • Perform staff coding audit, monitors performance and completes summary reports for management.
  • Refer problem accounts to appropriate coding or management personnel for resolution.
  • Responsible for assigning PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation.
  • Supervises staff including assignments and Kronos approval and sign offs, as well as, assist with recruitment.
  • Train all new Coders to observe established coding guidelines and to utilize the appropriate billing system.
  • 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.
  • Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions.

Qualifications

  • High school graduate or equivalent. 
  • Graduate of an approved certified coding program preferred. 
  • Proficient computer skills with MS excel knowledge preferred. 
  • Five years surgical coding experience (includes anesthesia coding) or advanced E/M coding experience. 
  • Two years training or supervisory experience required.

Licensure, Certifications, and Clearances:
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) specialty certification required

  • Act 34 Criminal Clearance
  • Certified Coding Specialist or Certified Professional Coder or Registered Health Information Administrator or Registered Health Information Technician

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

Salary Range: $24.27 to $41.99

Union Position: No

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


WORKING HERE



Now more than ever, YOU can help us shape our communities and UPMC into a better place for everyone to work, study, play, and thrive.

Learn more about working here and check out our policies and recent updates.


UPMC Ranked #17 Best Places for Women & Diverse Managers in 2018

Share:
Talent Network