Coder II, Profee (Orthopaedic Surgery) - Pittsburgh, PA

VetJobs; Pittsburgh (Allegheny County); On-site; USD 28,000 - 44,000; Full time

Job summary

University of Pittsburgh Physicians is seeking a full-time Coder II for on-site work at the Pittsburgh facility. The role involves reviewing physician and nursing documentation to determine codes, applying ICD and CPT codes to substantiate medical necessity, and resolving denials to maximize reimbursement.

The position requires a high school/GED and a certified coding program; CPC certification is preferred. Hours are 7am–3:30pm, with some flexibility, Monday through Friday.

Qualifications

• High school graduate or equivalent.
• Graduate of an approved certified coding program preferred.
• Proficient with MS Excel.

Responsibilities

• Review pertinent physician, nursing and ancillary documentation to determine codes and medical necessity.
• Assign ICD and CPT codes for all record types to ensure accurate reimbursement.
• Resolve coding edits and denials in a timely manner to maximize reimbursement.
• Refer problem accounts to coding or management for resolution.
• Query physicians to obtain missing documentation and clarify coding details.

Skills

MS Excel

Education

Graduate of an approved certified coding program

High School/GED

CPC certification

Tools

MS Excel

Job description

Job Description

On behalf of VetJobs/MilitarySpouseJobs, thank you for your interest. We are assisting our partnering company, listed below, with this position. It is open to Veterans, Transitioning Military, National Guard Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow for next steps.

Job ID: 8187156665

Status: Full-Time

Regular/Temporary: Regular

Shift: Day Job

Work Arrangement: On-siteWork Arrangement information

Facility: University of Pittsburgh Physicians

Department: 65535 POP15 Coding

Location: 3471 Fifth Avenue, Pittsburgh, PA

Union Position: No

Salary Range: $ 20.2-32.01 USD

UPMC Department of Orthopaedic Surgery is hiring a full-time Coder II to join their team! This is a Monday through Friday daylight position with no evenings or weekends. Hours are 7am to 3:30pm, but have some flexibility.

Purpose

Same responsibilities as a Coder I. Review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, determine level of acuity, procudure(s) performed, billable supplies and diagnosis to substantiate medical necessity. Review and sequence all codes to to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution.

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.

Qualifications

High school graduate or equivalent.

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.

In lieu of 2 years of coding experience with schooling, a minimum of 3 years experience or CPC certification required.

Licensure, Certifications, And Clearances

Eligible for CPC or CPC specialty certification.

Act 34 with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

Auto req ID

480686BR

Minimum Education Required

High School/GED

Job_Category

Medical

City*

Pittsburgh

State*

Pennsylvania

Job Code

Health-Services health-services

Affiliate Sponsor

UPMC