Coder III - Technical

UPMC Corporate Revenue Cycle Hiring a Coder III

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. In this role, you will monitor and respond to accounts on Pre-Bill edit and error reports. You will assist with training other coders as requested. The Coder III will perform PHC4 coding corrections; provide feedback to coders who made errors as well as monitor the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion timeframe. Additionally, you will review and respond to the Pre-Bill Edit report issues to ensure timely billing. As the Coder III, you will assist with special projects as requested.

We are seeking experienced Coders with a strong background in Interventional Radiology (IR) and Interventional Cardiology (IC) CPT coding. Qualified applicants should possess a minimum of three years of CPT coding experience.

If you are ready to take the next step in your coding career, look no further!

Responsibilities:

• 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.
• 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.
• 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.
• 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 the number of minutes/hours spent on non-coding tasks.
• 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 Specialists when applicable during query process.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Review coding for accuracy and completeness before 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.
• 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.

Qualifications:

• High School or GED equivalent.
• Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures.
• Three years hospital coding experience.
• CIRCC (Certified Interventional Radiology and Cardiovascular Coder) credential is preferred

Licensure, Certifications, and Clearances:

• Requires CCS or RHIT or RHIA or Certified Professional Coder certification
• Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Nationally Registered Certified Coding Specialist (NRCCS) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT)
• Certified Professional Coder (CPC)
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran