Job Description

Job Title: Coder II (Analyst)
Job ID: 750239
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:

Shape the world of health care by joining UPMC as a Coder II Analyst!  This role will have the responsibilities as a Coder I, which include reviewing all pertinent physician, nursing and ancillary documentation in the medical record, determining level of acuity, procedure(s) performed, billable supplies and diagnosis to substantiate medical necessity. This role will also review and sequence all codes to maximize reimbursement and address any potential bundling issues.  They will apply modifiers as needed.  LMRP/CCI edit and coding denial resolution.  This position will also be tasked with data analytics for the Corporate Revenue Cycle Team, which includes tracking data and reviewing trends within the department.

 

This position is scheduled for daylight shifts, Monday through Friday.  The position is based at the Quantum I building, but has the opportunity to work from home after training is complete and productivity is met. 

 

Responsibilities:
  • ·        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.

    ·        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.

    ·        Utilize computer applications and resources essential to completing the coding process efficiently.

    ·        Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.

    ·        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.

    ·        Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.

    ·        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.

    ·        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.


Qualifications

  • High school graduate or equivalent. 
  • Graduate of an approved certified coding program preferred. 
  • Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures. 
  • Proficient computer skills with MS excel knowledge preferred. 
  • In lieu of two years of coding experience with schooling, a minimum of three years experience or Certified Professional Coder (CPC) certification required.
  • Proficiency with Microsoft Excel is highly preferred.

Licensure, Certifications, and Clearances:
Eligible for Certified Professional Coder (CPC) or CPC specialty certification.

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

Salary Range: $16.23 to $25.77 / hour

Union Position: No

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