Coder II, Profee (Orthopaedic Surgery) - Pittsburgh, PA

Military Spouse Corporate Career Network•Pittsburgh, PA

3d•Onsite

About The Position

UPMC Department of Orthopaedic Surgery is hiring a full-time Coder II to join their team! This is a Monday through Friday daylight position with no evenings or weekends. Hours are 7am to 3:30pm, but have some flexibility. The Coder II has the same responsibilities as a Coder I, which includes reviewing all pertinent physician, nursing, and ancillary documentation in the medical record. Depending on the type and place of service, the coder determines the level of acuity, procedures performed, billable supplies, and diagnosis to substantiate medical necessity. They review and sequence all codes to maximize reimbursement and address potential bundling issues, and apply modifiers as needed. This role also involves LMRP/CCI edit and coding denial resolution.

Requirements

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.
Eligible for CPC or CPC specialty certification.
Act 34 with renewal

Nice To Haves

MS excel knowledge

Responsibilities

Utilize computer applications and resources essential to completing the coding process efficiently.
Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.
Refer problem accounts to appropriate coding or management personnel for resolution.
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.
Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.
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.
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) and to determine the level of acuity.
Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
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.
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.