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Certified Coding Specialist II-Profee

Remote:

Full Remote

Contract:

Full time

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

High school graduate or equivalent, Five years surgical coding experience, Two years training or supervisory experience, Graduate of an approved certified coding program preferred, CPC or CCS specialty certification required.

Key responsabilities:

Lead and assist with departmental coding audits
Analyze edit and denial data for process improvement
Monitor billing performance for optimal reimbursement
Train new Coders on established guidelines
Assist with recruitment and evaluate staff performance

UPMC XLarge https://www.upmc.com/

10001 Employees

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Job description

Your missions

UPMC is seeking to hire a Certified Coding Specialist II to join our Coding Department. This is a work-from-home position, working Monday through Friday during standard business hours.
In this role, you will have all the responsibilities of the Coding Specialist plus assist with staff management. You will work to develop new processes and workflows to address issues by analyzing edit and denial data. Additionally, you will act as a liaison for the decentralized coding departments. Works with other departments to develop or enhance automated coding and coding interfaces. Assists manager with recruitment and evaluation processes.
We are looking for someone with a strong background in Evaluation and Management auditing as well as provider education to join the team. Apply today!
Responsibilities:

Demonstrate proficiency on billing system functionality, computer applications and resources essential to completing the coding process.
Lead, participate in and/or assist with departmental coding audits.
Investigate, resolve and analyze edits and denials and provide reports for process improvement, as necessary.
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). Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding.
Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
Perform staff coding audits, monitor performance, and complete summary reports for management.
Complete work assignments in a timely manner and adhere to department charge lag goals and understand the workflow of the department.
Refer problem accounts to appropriate coding or management personnel for resolution.
Supervises staff including assignments and Kronos approval and sign-offs, as well as, assist with recruitment.
Train all new Coders to observe established coding guidelines and utilize the appropriate billing system.
Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification.
Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions.
Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements.
Responsible for assigning PQRS codes and assists in the development of templates and processes to obtain the appropriate documentation.
Make forward progress within the training period toward meeting coding accuracy standards of the department 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 and provide education to physicians to accurately complete the coding process.
High school graduate or equivalent.
Five years surgical coding experience (including anesthesia coding) or advanced E/M coding experience.
Two years training or supervisory experience required.
Graduate of an approved certified coding program preferred.
Proficient computer skills with Microsoft excel knowledge preferred

Licensure, Certifications, and Clearances:

CPC or Certified Coding Specialist (CCS) specialty certification required
Certified Coding Specialist (CCS) OR Certified Outpatient Coder (COC) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT)
Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran
Annual

Required profile

Experience

Level of experience: Mid-level (2-5 years)

Spoken language(s):

Check out the description to know which languages are mandatory.

Hard Skills

CPT Coding Process Improvement Staff Management

Soft Skills

Analytical Thinking
Problem Solving
microsoft-excel
training-and-development
verbal-communication-skills
Detail-Oriented

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