[Hiring] Coder II, Profee (ENT Coding) @UPMC

Role Description

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours.

This role will have the same responsibilities as a Coder I, including:

• Reviewing all pertinent physician, nursing, and ancillary documentation.
• Determining the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity.
• Reviewing and sequencing all codes to maximize reimbursement and address potential bundling issues.
• Applying modifiers as needed.
• Handling LMRP/CCI edit and coding denial resolution.

We are looking for coders with prior experience in ENT coding to join the team. If you are ready to take the next step in your coding career, look no further!

Responsibilities include:

• Utilizing computer applications and resources essential to completing the coding process efficiently.
• Meeting and maintaining charge lag and appropriate coding productivity standards within the time frame established by management staff.
• Referring problem accounts to appropriate coding or management personnel for resolution.
• Identifying incomplete documentation in the medical record and formulating a physician query to obtain missing documentation and/or clarification.
• Monitoring and resolving coding edits and denials in a timely manner to ensure optimal reimbursement.
• Making forward progress toward meeting coding accuracy standards within the first year of employment.
• Utilizing standard coding guidelines, principles, and coding clinics to assign appropriate ICD and CPT codes for all record types.
• Reviewing coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
• Adhering to internal department and system-wide competencies, behaviors, policies, and procedures.
• Actively participating in monthly coding meetings and sharing ideas for operational improvements.
• Maintaining continuing education by reviewing updated CPT assistant guidelines and coding clinics.
• Completing work assignments in a timely manner and understanding the workflow of the department.
• Maintaining daily productivity statistics and submitting a weekly productivity sheet to management.

Qualifications

• High school graduate or equivalent.
• In lieu of 2 years of coding experience with schooling, a minimum of 3 years experience or CPC certification required.
• Graduate of an approved certified coding program preferred with a curriculum that 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.

Requirements

• Eligible for CPC or CPC specialty certification.
• Act 34 clearance.

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.