Coder I - Profee

UPMC

10h•Remote

About The Position

UPMC Corporate Revenue Cycle is hiring a Coder I - Profee to join its Coding Department. This is a work-from-home position with a Monday-through-Friday schedule during business hours. The coder assigns ICD and limited CPT codes, reviews physician documentation to determine appropriate ICD-10 codes, verifies CPT codes, and assigns basic CPT codes in some cases. The role resolves basic coding edits, completes the charging process, and ensures diagnosis codes meet local medical necessity guidelines for ordered ancillary tests. The position requires knowledge of billing and coding guidelines and use of resources such as CCI edits, 3M, ICD and CPT publications, and applicable specialty reference materials to ensure accurate coding.

Requirements

High school graduate or equivalent.
Proficient computer skills.
In lieu of a completed coding externship, six months of experience.
Act 34 clearance.

Nice To Haves

Graduate of an approved certified coding program, preferably with coursework in Anatomy and Physiology, Medical Terminology, ICD-10-CM, and CPT Coding Guidelines and Procedures.
Knowledge of Microsoft Excel.

Responsibilities

Use standard coding guidelines, principles, and coding clinics to assign appropriate ICD and CPT codes and ensure accurate reimbursement.
Review coding for accuracy and completeness before submission to the billing system, using CCI edits.
Complete work assignments on time and understand departmental workflow.
Maintain daily productivity statistics and submit a weekly productivity sheet to management.
Identify incomplete medical-record documentation and formulate physician queries to obtain missing information or clarification for accurate coding.
Use computer applications and resources to complete coding and efficiently resolve basic coding edits.
Refer problem accounts to appropriate coding or management personnel for resolution.
Meet and maintain charge-lag and coding-productivity standards within management-established timeframes.
Follow internal and system-wide competencies, behaviors, policies, and procedures.
Participate in monthly coding meetings and share ideas and suggestions for operational improvements.
Maintain continuing education by reviewing updated CPT assistant guidelines and coding clinics.
Make progress toward departmental coding-accuracy standards during the training period and within the first year of employment.
Meet appropriate coding-productivity standards within the timeframes established by management.