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UPMC Community Medicine Incorporated is hiring a full-time Coder II, PSD to support Tri-State Neuro Assoc/Ortho Spine Assoc located at 9100 Babcock Blvd, Pittsburgh, PA 15237 &12680 Perry Highway, Wexford, PA 15090. This role will work Monday through Friday 8am to 4:30pm. This role will require occasional travel to outpatient clinics as needed due to staff time off (New castle, Greenville, Monroeville, Wexford).

This role will be primarily responsible for coding operative reports, working practice work queues, appealing claims, preregistering patient to verify insurance, possible front desk clinic coverage, and provide different reports to physicians (and other duties as assigned). The ideal candidate will have in depth knowledge of using Excel.

Responsibilities:

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

+ Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff.

+ Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement.

+ 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.

+ Utilize computer applications and resources essential to completing the coding process efficiently.

+ 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.

+ 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.

+ 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.

+ 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.

+ 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.

+ Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran