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Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

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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Supervisor, Coding

  • Job ID: 344993108
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc Coding
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $24.78 to $42.84 / hour

Description

UPMC Corporate Revenue Cycle is hiring a Supervisor, Coding to join our team!  This position will work Monday through Friday during daylight hours.  The position will be fully remote!

The Supervisor will provide training and education to UPMC outpatient clinics and Ancillary areas coding staff.  The role performs quality-coding audits and provides results to Clinical Administration.  As well as achieving optimal reimbursement and ensure appropriate application of ICD-9-CM, and CPT/HCPCS codes based on documentation for the outpatient setting. The Supervisor educates staff of the established classification guidelines for outpatient coding under the Outpatient Perspective Payment System.  As well as ensuring that Ambulatory Payment Groups (APC's) have been appropriately assigned for optimal reimbursement and compliance with all Federal and State mandates and OIG guidelines regarding reimbursement are strictly adhered to.

Looking to advance in your coding career?  If so, apply today!

Responsibilities:

  • Communicate identified issues to the clinic.
  • Complete and submit a bi-weekly status report indicating meetings attended and outcomes achieved, seminars attended or presented, and audits completed or in progress.
  • Advise clinic management of discrepancies and facilitate corrective actions.
  • Provide assistance regarding diagnosis verification as requested.
  • Discuss identified issues and supporting documentation of reviews with clinic management.
  • Send clinic's response regarding resolution via the Cirius report back to Patient Business Services within 48 hours.
  • Conduct quarterly audits according to established clinic/ancillary schedule by reviewing the ICD-9-CM codes, CPT/HCPCS codes, facility levels, modifiers, date of service, charges, and supporting documentation.
  • Inform the Coding Manager of scheduled audit summaries with clinical managers.
  • Educate new and established outpatient hospital based clinic/ancillary personnel to the disciplines of ICD-9-CM CPT/HCPCS, coding including modifiers, and outpatient coding guidelines to ensure quality outpatient coding and appropriate ambulatory payment classification (APC) assignment.
  • Investigate claim denials on the Cirius report initiated by Patient Business Services, by thorough review of documentation and assignment of ICD-9 and CPT/HCPCS codes and modifiers according to Medicare ambulatory payment classification guidelines and specific payor reimbursement.
  • Provide audit results to clinic administration on a quarterly basis utilizing the outpatient audit summary form, which contains the following information: purpose, background, sample size, identified issues, responsible person, actions and follow-up.
  • Monitor the 661 unbilled report on a weekly basis for accounts greater than three days. A spreadsheet is created and provided to all clinic management for resolution.
  • Promote continuous communication with Patient Business Services by reviewing and providing resolution of accounts on the Cirius report on a daily basis to support optimal reimbursement and minimize billing denials.
  • Provide training as needed regarding the application of coding guidelines and principles, correct utilization of the ICD-9 coding book and the MEDIPAC abstracting/coding functions to ensure that accurate ICD-9-CM, CPT./HCPCS codes and modifier information is submitted to Patient Business Services.
  • Keep current with Medicare and APC changes by reading reference materials, coding subscriptions and coding manual updates that are provided on a monthly basis within the Health Information Management Coding Department.
  • Maintain current ambulatory classification (APC) and coding knowledge of ICD-9, CPT/HCPCS, and Modifiers through attendance at in-services and coding seminars.
  • Develop and present coding seminars to clinic managers and staff based on identified coding issues.
  • Attend monthly meetings with the Coding Manager, Associate Director and Director.

 

Qualifications

  • Completion of an approved registered Health Information Administration program or Registered Health Information (RHIA/RHIT or eligible) or equivalent education/training required.
  • Previous coding experience in a Health Information Management (HIM) Department or related experience within a large multi-hospital environment required.
  • Experience must be related to the Perspective Payment in particular APC payment classifications.
  • Strong knowledge of anatomy, physiology, pharmacology and medial terminology required.
  • The principles of ICD-9-CM and CPT/HCPCS coding classification systems must be mastered.
  • Excellent organizational skills; communication skills: both verbal and written; and a strong computer background.
  • Must possess and apply analytical skills and work independently to establish priorities.
  • The ability to work cooperatively with clinic managers and staff is essential.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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