Coder II (ENT Coding)

UPMC; Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare institution is seeking a Coder II to work from home, Monday to Friday. The role involves reviewing medical documentation for coding accuracy and maximizing reimbursements, particularly in ENT surgical coding. Candidates should have a high school diploma, experience in coding, and a CPC certification is preferred. Proficient skills in ICD and CPT coding are required, ensuring compliance with internal standards and guidelines. This position promises a dynamic contribution to the healthcare revenue cycle.

Qualifications

• Prior experience in ENT surgical coding is required.
• Understanding of anatomy and physiology, pharmacology, and medical terminology is essential.
• Eligible for CPC or CPC specialty certification.

Responsibilities

• Utilize computer applications essential for coding.
• Meet coding productivity standards set by management.
• Monitor and resolve coding edits and denials for optimal reimbursement.

Skills

ENT surgical coding

Proficient computer skills

ICD and CPT coding

Education

High school graduate or equivalent

Graduated from an approved certified coding program

CPC certification

Tools

MS Excel

Job description

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee! 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 ENT surgical 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.
• 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

EEO Statement

UPMC is an Equal Opportunity Employer/Disability/Veteran