Coder II - Profee

UPMC

Pittsburgh (Allegheny County)

Remote

USD 50,000 - 70,000

Full time

14 days+

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Job summary

A leading healthcare provider is seeking a Coder II - Profee to assist with coding for general surgery. This full-time remote position requires prior experience in physician coding and knowledge of coding guidelines to maximize reimbursement. Join a dynamic team focused on accuracy and effective reimbursement processes.

Qualifications

Graduate of an approved certified coding program preferred.
In lieu of 2 years of coding experience with schooling, a minimum of 3 years of experience or CPC certification is required.

Responsibilities

Utilize computer applications for efficient coding.
Monitor and resolve coding edits and denials.
Formulate physician queries for missing documentation.

Skills

Experience in physician coding

Proficient computer skills

Knowledge of ICD-9-CM and CPT coding

Education

Graduate of an approved certified coding program

High school graduate or equivalent

Tools

MS Excel

Job description

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UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to assist with general surgery coding! This position will be a work-from-home position working Monday through Friday during business hours.

This role will have the same responsibilities as a Coder I. The position will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. As well as review and sequence all codes to maximize reimbursement and address any potential bundling issues. The Coder II will apply modifiers as needed. The position will also handle LMRP/CCI edit and coding denial resolution.

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

Responsibilities:

Utilize computer applications and resources essential to completing the coding process efficiently.
Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.
Refer problem accounts to appropriate coding or management personnel for resolution.
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.
Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.
Make forward progress within the 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.
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) and to determine the level of acuity. Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
Adhere to internal department 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.
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.
High school graduate or equivalent.
In lieu of 2 years of coding experience with schooling, a minimum of 3 years of experience or CPC certification is required.
Graduate of an approved certified coding program preferred. Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM and CPT Coding Guidelines and Procedures.
Proficient computer skills with MS excel knowledge preferred.

Licensure, Certifications, and Clearances: