Certified Professional Coder (General Surgery Coding)

UPMC; Northern (KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

UPMC Corporate Revenue Cycle is seeking a Certified Professional Coder to join our coding team on a remote basis. The ideal candidate has three years of coding experience and specializes in general surgery coding, including PQRS codes.

Responsibilities include identifying incomplete documentation, assigning ICD and CPT codes, addressing denials, assisting in template development, training staff, and providing feedback to physicians. Hours are Monday through Friday during normal business times.

Qualifications

• Minimum three years of medical coding experience.
• Experience with general surgery coding required.
• Familiarity with PQRS codes preferred.
• Strong attention to detail and documentation accuracy.

Responsibilities

• Identify incomplete documentation and query physicians for missing information.
• Refer problem accounts for resolution by coding or management personnel.
• Meet coding accuracy standards and productivity targets within the first year.
• Provide training on code selection for staff and new coders.
• Investigate and resolve reimbursement issues, including denials, in a timely manner.
• Assign PQRS codes and assist in template development to obtain documentation.
• Apply ICD/CPT guidelines and review coding for accuracy prior to submission.
• Maintain productivity statistics and contribute to departmental audits.

Skills

Medical coding

General surgery coding

PQRS coding

Communication

Job description

UPMC Corporate Revenue Cycle is hiring a Certified Professional Coder to join our coding team to work on general surgery 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 general surgery coding expereince.

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.
• Provide 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.