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Coder II - Technical

  • Job ID: 06793872
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Hamot
  • Department: Plastic Surgery-Kang
  • Location: 100 Peach St, Erie PA 16507
  • Union Position: No
  • Salary Range: $14.70 to $22.53 / hour

Description

Purpose:
Join the Erie UPMC team as a Coder II-Technical!  This role will be responsible for E/M coding in a high volume plastic surgery setting.  The Coder II is responsible for coding diagnosis & procedure codes ICD-10 & CPT codes and charging for injections, infusions, hydrations, and observation hours. This full time role is Monday through Friday during normal business hours.

Responsibilities:
  • Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
  • Adhere to internal department 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 attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics.
  • Make forward progress within the training period toward meeting coding accuracy standards of 98% within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
  • Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and CPT codes (DSM IV if applicable). Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding.
  • Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories. If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database. Correct any data to be in error after reviewing the medical record and comparing with system entries.
  • 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 clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks.
  • Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients.
  • 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. Consult with DRG Specialist when applicable during query process.

Qualifications

  • High School or GED equivalent. 
  • Completed an AHIMA or AAPC-certified Coding program, Bidwell Training School or equivalent program. 
  • Curriculum includes Anatomy, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures.  Physiology and Pharmacology a plus.
  • Two years hospital or outpatient professional coding experience.

Licensure, Certifications, and Clearances:
Eligible for CPC, RHIA, RHIT, CCS


  • Act 31 Child Abuse Reporting with renewal
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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