Coder ii - technical

UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours.

In this role, you will be responsible for coding diagnosis & procedure codes ICD10 & CPT codes and charging for injection, infusion, hydration, and observation hours.

We are looking for coders with prior same-day surgery coding experience to join the team. If you are ready to take the next step in your coding career, look no further!

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.

High School or GED equivalent.

Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures.

Outpatient: pharmacology is taught on the job during training; pathophysiology not required.

Inpatient: Pharmacology & pathophysiology coursework required.

2 years hospital coding experience.

Licensure, Certifications, and Clearances:

• Eligible for RHIA, RHIT, CCS
• Act 34 with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran