Job Description

Job Title: Coder II, Profee
Job ID: 59967697
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:
Take the next step in your coding career and join the team as a Coder II, Profee!  This role supports the "edits" team.  It will have the same responsibilities as a Coder I. The Coder II will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, this role will determine level of acuity, procedure(s) performed, billable supplies and diagnosis to substantiate medical necessity. The Coder will review and sequence all codes to to maximize reimbursement and address any potential bundling issues. They will also apply modifiers as needed. LMRP/CCI edit and coding denial resolution.

This is a Monday through Friday role based at the Quantum building.  It has the ability to work from home after training is complete and productivity is met.

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.  
  • 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 CPC certification required.

Licensure, Certifications, and Clearances:
Eligible for CPC or CPC specialty certification.


UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $16.72 to $26.54 / hour

Union Position: No

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