Description

UPMC is hiring a full time Coder I to join their Physician Services team in Penn Hills, PA! This position will work with the Women's Health Department which provides general OB/GYN services and subspecialty services. The position will spend a lot of time working with the Center for Fertility and Reproductive Endocrinology which offers a woman-focused approach, knowledge, and expertise to provide highly personalized reproductive health care, including evaluation, diagnosis, and treatment. The Center provides the most recent advances in virtually all aspects of reproductive healthcare. The Center is designed to address all aspects of women's reproductive healthcare and includes psychosocial as well as medical and surgical services.

Hours for this position will Monday through Friday, daylight hours. This position will be a hybrid work opportunity with 3 to 4 days per week at home, after completion successful training.

Assign ICD and limited CPT codes. Coder reviews the physician documentation to determine the appropriate ICD-9 code and primarily verifies the CPT code, but in some cases assigns basic CPT codes. Resolves basic coding edits. Completes charging process. Ensures diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered- requires knowledge of billing and coding guidelines. Utilize coding resources (CCI edits, 3M, ICD and CPT Publications) along with any other applicable specialty reference material to ensure accurate coding.

Responsibilities:

• 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.
• Utilize computer applications and resources essential to completing the coding process and to resolve basic coding edits efficiently.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Adhere to internal 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.
• Meet and maintain charge lag and coding productivity standards within the time frame established by management staff.
• 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.
• Make forward progress within the training 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.
• Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to ensure accurate reimbursement. Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.

Qualifications

High school graduate or equivalent.

Graduate of an approved certified coding program preferred. OR Completed UPMC sponsored Coding program.

Curriculum includes Anatomy and Physiology, Medical Terminology, ICD-9-CM and CPT Coding Guidelines and Procedures.

Proficient computer skills with MS excel knowledge preferred. In lieu of completed coding externship, 6 months experience.

Licensure, Certifications, and Clearances:

• Act 34
• 
  UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC has a Center for Engagement and Inclusions that is charged with executing leading-edge and next- generation diversity strategies to advance the organization's diversity management capability and its national presence as a diversity leader. This includes having Employee Resources Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Difference) Network, that support the implementation of our diversity strategy.

Individuals hired into this role must comply with UPMC's COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.