Coder II - Technical (Inpatient Coding)

UPMC; Pittsburgh (Allegheny County); On-site; USD 65,000 - 90,000; Full time

Job summary

UPMC is seeking a Coder III for inpatient coding within our Corporate Revenue Cycle. The role is remote, with standard business hours Monday through Friday. You will code inpatient accounts using ICD-10-CM and PCS, reviewing records for accuracy and aligning with Official Coding Guidelines.

The position requires high school or GED, 2 years hospital coding experience, and AHIMA/AACP coding certification or equivalent coursework. RHIA/RHIT/CCS eligibility and related clearances are a plus.

Qualifications

• High School or GED is required.
• Completion of AHIMA or AACP coding program or certificate required.
• Coursework or certification covering anatomy & physiology, pharmacology, pathophysiology, medical terminology, ICD-9/10 and CPT guidelines.

Responsibilities

• Code all diagnoses and procedures with ICD-10-CM and PCS codes after reviewing the medical record.
• Review coding for accuracy before submission to billing using CCI edits.
• Adhere to department policies; participate in monthly coding meetings and ongoing education.
• Meet coding productivity standards within established time frames.
• Use Optum coding application; abstract data as needed and ensure data accuracy in systems.
• Refer problem accounts to appropriate coding/management personnel for resolution.
• Maintain productivity statistics and weekly records of hours and charts processed.
• Identify missing documentation and request physician queries; consult DRG Specialist as needed.
• Inpatient work requires pharmacology and pathophysiology coursework.

Education

High School or GED equivalent

AHIMA/AACP-certified Coding program or certificate

Curriculum including Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures

Tools

Optum coding application

Job description

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

This position will be working on inpatient codes. As the Coder II, Technical you will code all inpatient accounts, ICD10 diagnoses, and PCS procedures.

Responsibilities

• Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and PCS codes following review of the medical record in the electronic health record. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the EHR available at the time of coding adhering to Official Coding Guidelines.
• Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits as published in Optum . Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD10-CM and PCS codes for all record types to ensure accurate reimbursement.
• 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 guidelines and updated coding clinics.
• Make forward progress within the training period toward meeting coding accuracy. Meet appropriate coding productivity standards within the time frame established by management staff.
• Utilize computer applications and resources essential to completing the coding process efficiently, such as the Optum coding application. 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 electronic health 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.
• Identify incomplete documentation in the medical record and recommend 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.
• High School or GED equivalent.
• Two years of hospital coding experience.
• Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculm that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures.
• Experience with PCS codes is preferred
• Inpatient: Pharmacology & pathophysiology coursework required

Licensure, Certifications, and Clearances

• Eligible for RHIA, RHIT, CCS
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran