Coder I - Profee

UPMC; Northern (KY); Hybrid; USD 45,000 - 65,000; Full time

Job summary

UPMC Corporate Revenue Cycle is hiring a Coder I- Professional Fee to join our Coding Department. This will be a work-from-home position with standard Monday through Friday business hours.

You will assign ICD and limited CPT codes by reviewing physician documentation to determine the appropriate ICD-10 code and verify CPT codes, ensuring alignment with local medical necessity guidelines for ancillary tests.

Responsibilities

• Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to ensure accurate reimbursement.
• Review coding for accuracy and completeness prior to submission to the billing system utilizing CCI edits.
• 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.
• Utilize computer applications and resources essential to completing the coding process and to resolve basic coding edits efficiently.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Meet and maintain charge lag and coding productivity standards within the time frame established by management staff.
• 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.
• Make forward progress within the training period toward meeting coding accuracy standards of the departments within the first year of employment.

Job description

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

In this role, you will assign ICD and limited CPT codes. Coders will review the physician documentation to determine the appropriate ICD-10 code and verify the CPT code, but in some cases assign basic CPT codes. Additionally, you will resolve basic coding edits, complete the charging process and ensure diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered. This role requires knowledge of billing and coding guidelines. Utilize coding resources (CCI edits, 3M, ICD and CPT Publications) along with any other applicable specialty reference material to ensure accurate coding.

Responsibilities:

• Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to ensure accurate reimbursement. Review coding for accuracy and completeness prior to submission to the billing system utilizing CCI edits.
• 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.
• 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.
• Utilize computer applications and resources essential to completing the coding process and to resolve basic coding edits efficiently.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Meet and maintain charge lag and coding productivity standards within the time frame established by management staff.
• 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.
• 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.