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UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Certified Coding Specialist I- Medicare HCC (REMOTE)

  • Job ID: 220000YW
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: MEDICARE HCC
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: non union
  • Salary Range: $24.78 to $42.84 / hour

Description

UPMC's Medicare HCC Risk department is hiring a remote Certified Coding Specialist!
Ability to code using ICD-10-CM and appropriately assigning diagnosis and procedure codes after reviewing all documentation available. Performs audits to determine accuracy of code selection. Responsible for validating diagnoses submitted via claims to the Health Plan by reviewing inpatient, outpatient, and provider office documentation.

This is a REMOTE position. 

Responsibilities:

 

  • Code Inpatient, Outpatient, physician, and ED charts as necessary.
  • Assign Risk Adjustment HCC diagnoses by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology, and pathology.
  • Review the discharge summary, history and physical, physician progress notes, consultation reports, operative records, emergency room record to accurately assign a diagnosis and / or procedure.
  • Review appropriate documents to accurately assign a Risk Adjustment HCC diagnosis.
  • Review coding for accuracy and completeness prior to submission.
  • Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-10-CM and CPT codes.
  • Utilize computer applications and resources essential to completing the coding process efficiently.
  • Responsible for correcting any data found to be in error after reviewing the medical record and comparing with system entries.
  • Complete work assignments in a timely manner.
  • Meet coding accuracy standards of 95% as well as coding productivity standards.
  • Complete coder productivity and time log daily.
  • 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.
  • Performs in accordance with system-wide competencies/behaviors.
  • Performs other duties as assigned.

Qualifications

 

  • Graduate of an AHIMA (American Health Information Management Association) or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology.
  • Five (5) years of total experience.
  • Knowledge of Microsoft Office.


Licensure, Certifications, and Clearances:
Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) required.
 

  • Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC)

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct