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UPMC continues to comply with governmental guidance related to local, state, and federal COVID-19 vaccination for employment. All employees and affiliated staff of UPMC entities are considered essential health care workers and will be accountable to follow the Centers for Medicare & Medicaid Services (CMS) federal vaccine mandate. To be compliant with the federal mandate, employees must complete the approved vaccination dosage regimen currently defined by the federal government. Compliance with the federal mandate is encouraged before hire. Medical and religious exemption requests may be submitted for consideration.

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Coder III - Technical

  • Job ID: 637681856
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc Coding
  • Location: 2 Hot Metal Street, Pittsburgh PA 15203
  • Union Position: No
  • Salary Range: $18.78 to $31.22 / hour

Description

Take the next step in your coding career and join the team as a Coder III, Technical! This is a full-time remote role working regular business hours Monday through Friday. 

All responsibilities of coder trainee, coder I, II plus the following: Monitor and respond to accounts on Pre-Bill edit and error reports. Assist with training other coders as requested. Performs PHC4 coding corrections; provides feedback to coders who made errors. Monitor the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion timeframe. Review and respond to the Pre-Bill Edit report issues to ensure timely billing. Assist with special projects as requested.
Apply today!

Responsibilities:
  • 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.
  • 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-9-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.
  • 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.
  • 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 the number of minutes/hours spent on non-coding tasks.
  • 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 the query process.
  • Refer problem accounts to appropriate coding or management personnel for resolution.
  • 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-9-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.
  • 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 the accuracy of the database. Correct any data to be in error after reviewing the medical record and comparing with system entries.

 

Qualifications

  • High School or GED equivalent.
  • Completed an AHIMA or AACP-certified Coding program, Bidwell Training School or equivalent program.
  • Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM and CPT Coding Guidelines and Procedures.
  • Three years of hospital coding experience.

Licensure, Certifications, and Clearances:
  • Requires Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT)
UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct