Remote Coder II — ICD/CPT for Denials & Reimbursement

UPMC; Pittsburgh (Allegheny County); Remote; USD 39,000 - 52,000; Full time

Job summary

UPMC Corporate Revenue Cycle is seeking a Coder II for a remote, Monday–Friday position within the Coding Department. The role emphasizes evaluating and coding physician, nursing, and ancillary documentation to determine acuity, procedures, and billable items to support medical necessity and maximize reimbursement.

You will apply ICD and CPT codes, resolve denials, and query missing documentation while maintaining productivity and accuracy.

Qualifications

• Strong understanding of Evaluation and Management codes.
• Proficient computer skills with MS Excel.

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.

Skills

Understanding of E/M codes

Education

High school diploma or equivalent

CPC certification

Tools

MS Excel

Job description

UPMC Corporate Revenue Cycle is seeking a Coder II for a remote, Monday–Friday position within the Coding Department. The role emphasizes evaluating and coding physician, nursing, and ancillary documentation to determine acuity, procedures, and billable items to support medical necessity and maximize reimbursement.

You will apply ICD and CPT codes, resolve denials, and query missing documentation while maintaining productivity and accuracy.