Orthopaedic Coder II - Day Shift with Flexible Hours

UPMC; Pittsburgh (Allegheny County); On-site; USD 60,000 - 90,000; Full time

Job summary

UPMC Department of Orthopaedic Surgery is seeking a full-time Coder II to join their team. This daylight position runs Monday through Friday from 7:00 am to 3:30 pm with some flexibility.

The role reviews physician, nursing and ancillary documentation to assign accurate ICD and CPT codes, maximize reimbursement and resolve denials. CPC certification or completion of an approved coding program is preferred, with 3 years' experience or CPC required.

Qualifications

• High school graduate or equivalent.
• Graduate of an approved certified coding program preferred.
• Eligible for CPC or CPC specialty certification.

Responsibilities

• Review all pertinent physician, nursing and ancillary documentation in the medical record.
• Determine level of acuity, procedure(s) performed, billable supplies and diagnosis to substantiate medical necessity.
• Review and sequence all codes to maximize reimbursement and address any potential bundling issues.
• Apply modifiers as needed.
• Edit according to LMRP/CCI and coding denial resolution.
• Identify incomplete documentation and formulate physician queries for clarification.
• Monitor and resolve coding edits and denials to ensure optimal reimbursement.
• Adhere to coding guidelines and participate in ongoing education.

Education

High school diploma or equivalent

Certified coding program

CPC certification

Tools

MS Excel

Job description

UPMC Department of Orthopaedic Surgery is seeking a full-time Coder II to join their team. This daylight position runs Monday through Friday from 7:00 am to 3:30 pm with some flexibility.

The role reviews physician, nursing and ancillary documentation to assign accurate ICD and CPT codes, maximize reimbursement and resolve denials. CPC certification or completion of an approved coding program is preferred, with 3 years' experience or CPC required.