Coder II - Technical

UPMC; Pittsburgh (Allegheny County); Remote; USD 58,000 - 75,000; Full time

Job summary

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

In this role, you will be responsible for coding diagnosis & procedure codes ICD10 & CPT codes and charging for injection, infusion, hydration, and observation hours. We are looking for coders with prior same-day surgery coding experience to join the team.

Qualifications

• Prior same-day surgery coding experience.
• Ability to code ICD-10-CM and CPT diagnoses/procedures.
• Experience charging for injections, infusions, hydration, and observation hours.
• Commitment to department guidelines and ongoing education.

Responsibilities

• Review coding for accuracy before submission using CCI edits; assign ICD-10-CM, CPT and DSM IV codes.
• Adhere to department policies; participate in monthly coding meetings and pursue operational improvements.
• Maintain education by attending seminars and reviewing updated CPT Assistant guidelines and coding clinics.
• Meet 98% coding accuracy within first year and achieve productivity standards.
• Code all diagnoses and procedures with principal and secondary codes after reviewing available documentation.
• Utilize hospital information systems (Medipac/SMS/Meditech), encoders, and EMR repositories; ensure data accuracy.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Complete work assignments timely; maintain weekly productivity statistics and reports.
• Determine diagnoses and procedures and ensure proper sequencing for DRG/APC/ASC or payment tier.
• Identify incomplete documentation and formulate physician queries; consult DRG Specialist when needed.

Skills

ICD-10-CM coding

CPT coding

Surgical coding

Tools

Medipac/SMS/Meditech

Encoders

Job description

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

In this role, you will be responsible for coding diagnosis & procedure codes ICD10 & CPT codes and charging for injection, infusion, hydration, and observation hours.

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

Responsibilities:

• Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
• Adhere to internal department 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 attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics.
• Make forward progress within the training period toward meeting coding accuracy standards of 98% within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff.
• Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and CPT codes (DSM IV if applicable). Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding.
• Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories. If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database. Correct any data to be in error after reviewing the medical record and comparing with system entries.
• Refer problem accounts to appropriate coding or management personnel for resolution
• 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 clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks.
• Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients.
• 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. Consult with DRG Specialist when applicable during query process.