Certified Professional Coder

UPMC; Northern (KY); Hybrid; USD 65,000 - 85,000; Full time

Job summary

UPMC Corporate Revenue Cycle is seeking a Certified Professional Coder to join our cardiology/cardiothoracic coding team. This remote role operates Monday through Friday during normal business hours. A minimum of three years of coding experience is required with cardiology experience preferred.

You will assign PQRS codes, assist in template development, and provide feedback to physicians on coding and documentation. Training and audits are part of the responsibilities.

Qualifications

• Three years of medical coding experience required.
• Cardiology coding experience preferred.
• Knowledge of PQRS coding and documentation improvement.
• Familiar with CPT/ICD coding guidelines and audits.

Responsibilities

• Identify incomplete documentation and query physicians for clarification.
• Refer problem accounts to coding/management for resolution.
• Meet coding accuracy standards within the first year of employment.
• Provide training on code selection for new staff.
• Investigate and resolve reimbursement issues, including denials.
• Assign PQRS codes and assist in template development.
• Review coding for accuracy prior to submission using CPT/CCI guidelines.
• Maintain productivity statistics and reporting.
• Be a resource to other coding staff.
• Utilize coding resources to complete the process efficiently.
• Participate in departmental coding audits and meetings.
• Lead or assist with coding interface enhancements and changes.

Skills

Cardiology coding

Medical coding

Physician queries

Coding accuracy

Training others

Tools

CCI edits

CPT Assistant

Coding Clinics

ACEP acuity guidelines

Job description

UPMC Corporate Revenue Cycle is hiring a Certified Professional Coder to join our coding team to work on cardiology/cardiothoracic coding. This position will be a work-from-home position, working Monday through Friday during normal business hours. To be considered for this position, you must have three years of coding experience. We are looking for medical coders with cardiology coding experience.

In this role, you will have the same responsibilities as Coder II, but also be responsible for assigning PQRS codes and assist in the development of templates and processes to obtain the appropriate documentation. Provide feedback to the physicians on coding, documentation, edit, and denial issues.

Responsibilities:

• Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification and provide education to physicians to accurately complete the coding process.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Make forward progress within the training period toward meeting coding accuracy standards of the departments within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
• Provides training on code selection for new and existing staff.
• Investigate and resolve reimbursement issues, including denials, in a timely manner per department standards.
• Responsible for assigning PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation.
• Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD and CPT codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding.
• 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.
• Be a resource to other coding staff.
• Utilize computer applications and resources essential to completing the coding process efficiently.
• Adhere to internal and system-wide competencies, behaviors, 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 reviewing updated CPT assistant guidelines and updated coding clinics.
• Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions.
• Lead, participate in and/or assist with departmental coding audits.