Coder I - Technical

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

This role will be responsible for coding Outpatient Emergency Room accounts using ICD-10 and CPT codes.  As the Coder I, you will review the physician emergency report, nursing documentation, orders, diagnostic reports, labs, radiology and procedural notes to assign both ICD-10 diagnosis codes and CPT codes. You will follow ACEP Guidelines for acuity level assignment and drug administration charging.  As a Coder I you will ensure diagnosis codes meet local medical necessity guidelines for tests that were ordered. This will require knowledge of billing and coding guidelines.

Responsibilities:

• Code by assigning and verifying the principle and secondary diagnoses (ICD-10-CM) and procedures (CPT codes or DSM, IV if applicable) by thoroughly reviewing all documentation available at the time of coding.

• Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care are sequenced in order of their clinical significance to accurately assign the appropriate APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients.

• Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-9-CM/ICD-10-CM, CPT and DSM IV codes for outpatient records to ensure accurate reimbursement

• Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems, EHR information systems, encoders and electronic medical record repositories. If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database.

• Refer problem accounts to appropriate coding or management personnel for resolution.

• Complete work assignments in a timely manner and understand the workflow of the department including routing cases appropriately in the electronic systems.
  Complete a non coding time productivity sheet as required/applicable.

• Meet appropriate coding productivity and quality standards within the time frame established by management staff.

• Adhere to internal department 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 attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics.

• Performs in accordance with system-wide competencies/behaviors.

• Performs other duties as assigned.
   

• High School or GED equivalent. 
• Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Medical Terminology, ICD-9-CM/ICD 10 and CPT Coding Guidelines and Procedures. 
• Six months hospitals coding experience preferred.
   

Licensure, Certifications, and Clearances:

• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran