Role Description UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this role, you will be handling same-day surgery and observation coding: - Coding diagnosis & procedure codes ICD10 & CPT codes - Charging for injections, infusions, hydrations - Reconciling NCCI edits Responsibilities: - Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. - Utilize standard coding guidelines, principles, and coding clinics to assign appropriate ICD-10-CM, CPT, and DSM IV codes for all record types to ensure accurate reimbursement. - Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding or hospital specific acuity level module as needed. - 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. - Make forward progress within the training period toward meeting coding accuracy standards of 98% within the first year of employment. - Meet appropriate coding productivity standards within the time frame established by management staff. - Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and CPT codes (DSM IV if applicable). - Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding. - Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), 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. - Correct any data to be in error after reviewing the medical record and comparing with system entries. - 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. - Maintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. - Determine diagnoses that were treated, monitored, and evaluated and procedures done during the episode of care and assign appropriate codes. - Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. - Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients. - 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. - Consult with DRG Specialist when applicable during query process. Qualifications - High School or GED equivalent. - Two years of hospital coding experience. - Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures. - Outpatient: pharmacology is taught on the job during training; pathophysiology not required. - Inpatient: Pharmacology & pathophysiology coursework required. Requirements - Eligible for RHIA, RHIT, CCS - Act 34 Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.