Remote Medical Coder II: Reimbursement & Denials Expert

UPMC Altoona; Erie (Erie County); Remote; USD 52,000 - 78,000; Full time

Job summary

UPMC Altoona is seeking a Coder II, PSD to join our Regional Health Services team. This full-time role is remote, with a Monday–Friday day shift and some schedule flexibility. Occasional travel to practices may be requested to provide coding and billing education to providers and staff.

Responsibilities include reviewing medical records, determining acuity and procedures, applying modifiers, and resolving denials to maximize reimbursement. Strong coding knowledge and CPC eligibility preferred.

Qualifications

• 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.

Responsibilities

• Refer problem accounts to appropriate coding or management personnel for resolution.
• Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.
• Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.
• 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.
• Utilize computer applications and resources essential to completing the coding process efficiently.
• Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD and CPT codes for all record types to ensure accurate reimbursement.
• Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
• 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.
• 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.
• 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.

Education

High school diploma or equivalent

Certified coding program

Anatomy and Physiology knowledge

Tools

MS Excel

Job description

UPMC Altoona is seeking a Coder II, PSD to join our Regional Health Services team. This full-time role is remote, with a Monday–Friday day shift and some schedule flexibility. Occasional travel to practices may be requested to provide coding and billing education to providers and staff.

Responsibilities include reviewing medical records, determining acuity and procedures, applying modifiers, and resolving denials to maximize reimbursement. Strong coding knowledge and CPC eligibility preferred.