Certified Professional Coder

at  UPMC

UPMC Corporate Revenue Cycle is hiring a Certified Professional Coder to join our surgical coding team! We are looking for individuals with strong experience with Cardiology coding. This position will be a work-from-home position working Monday through Friday during normal business hours.
In this role, you will have the same responsibilities as Coder II, but also be responsible for assigning PQRS codes and assist in the development of templates and processes to obtain the appropriate documentation. Provide feedback to the physicians on coding, documentation, edit, and denial issues.

• Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification and provide education to physicians to accurately complete the coding process.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• 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 staff.
• Provides training on code selection for new and existing staff.
• Investigate and resolve reimbursement issues, including denials, in a timely manner per department standards.
• Responsible for assigning PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation.
• 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). Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding.
• 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.
• Be a resource to other coding staff.
• Utilize computer applications and resources essential to completing the coding process efficiently.
• 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.
• Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions.
• Lead, participate in and/or assist with departmental coding audits.
• High school graduate or equivalent.
• Three years of physician coding experience in the applicable specialty.
• Graduate of an approved certified coding program preferred.
• Proficient computer skills with MS excel knowledge preferred