Coder II, Profee (Orthopaedic Surgery) Pittsburgh, PA

Job Description
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Job ID:
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Work Arrangement: On-siteWork Arrangement information
Facility: University of Pittsburgh Physicians
Department: 65535 POP15 Coding
Location: 3471 Fifth Avenue Pittsburgh PA
Union Position: No
Salary Range: $ 20.2-32.01 USD

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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.

Purpose:
Same responsibilities as a Coder I. Review all pertinent physician nursing and ancillary documentation in the medical record. Depending on type of service and place of service determine level of acuity procudure(s) performed billable supplies and diagnosis to substantiate medical necessity. Review and sequence all codes to to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution.

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.
Qualifications:

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.
Licensure Certifications and Clearances:
Eligible for CPC or CPC specialty certification.



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UPMC is an Equal Opportunity Employer/Disability/Veteran

• 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.

• 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.