Role Description UPMC Corporate Revenue Cycle is hiring a Coder I- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. This position will be working on Professional (Physician) Coding Denials. We are looking for Coders who have prior denial experience. In this role, you will: - Assign ICD and limited CPT codes. - Review physician documentation to determine the appropriate ICD-10 code and primarily verify the CPT code, but in some cases, assign basic CPT codes. - Resolve basic coding edits, complete charge processing, and ensure diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered. - Utilize coding resources (CCI edits, 3M, ICD and CPT Publications) along with any other applicable specialty reference material to ensure accurate coding. Responsibilities: - Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to ensure accurate reimbursement. - Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. - 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. - 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. - Utilize computer applications and resources essential to completing the coding process and to resolve basic coding edits efficiently. - Refer problem accounts to appropriate coding or management personnel for resolution. - Meet and maintain charge lag and coding productivity standards within the time frame established by management staff. - Adhere to internal 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. - Make forward progress within the training 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. Qualifications - High school graduate or equivalent. - In lieu of completed coding externship, 6 months experience. - Graduate of an approved certified coding program preferred with a curriculum that includes Anatomy and Physiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures. - Proficient computer skills with MS Excel knowledge preferred. - Denial experience including appeals, coding experience is preferred. Requirements - Licensure, Certifications, and Clearances: Act 34. Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.

Role Description We are looking for a Billing & Coding Associate to work in the revenue cycle department to drive accounts receivable. In this role, you own the "Everything Surrounding Claims" space—ensuring that the full revenue cycle is being managed and claims are being paid. As a startup, we move fast. This role is for someone who loves to solve puzzles, thrives in a high-volume environment, and is comfortable with their daily tasks evolving as we build better systems. Responsibilities: What You’ll Do - Coding & Documentation: Review patient medical records to extract information and assign accurate diagnosis and procedure codes. - Claim Submission: Create, review, and submit clean claims to insurance payers using billing software. - Revenue Management: Follow up on unpaid claims, handle denials, initiate appeals, and manage accounts receivable. - Patient Interaction: Handle inquiries regarding bills, explain insurance coverage, and set up payment plans. - Team Communication: Weekly outreach for any items that are blocking billing must be completed in a professional and timely manner. - Compliance: Maintain strict confidentiality and adhere to HIPAA regulations and, if applicable, CMS guidelines. - Data Integrity: Maintain a 100% accuracy between codes assigned and documented time, ensuring every interaction is documented for clinical continuity and reimbursement. - Startup Agility: Assist the Revenue Cycle and Operations teams in testing new workflows, documenting "what works," and taking on special projects as the company scales. Qualifications - 1–3 years of experience as a biller and/or coder and equivalent education/certification. - Strong knowledge of ICD-10-CM, CPT, HCPCS is a must. - Certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Coding Associate (CCA) or equivalent is required. - Technical Native: You can navigate multiple software tools (Slack, EMRs, Google Suite) simultaneously without breaking a sweat. - Spreadsheet experience (preferably Google Sheets) is required. - Exceptional Communication: You are comfortable on the phone and in writing—able to explain complex insurance issues and relay details to appropriate parties. - Detail Obsessed: You notice the missing signature or the transposed phone number that others might miss. - The "Startup Spirit": You are comfortable with ambiguity and excited by the chance to help define a role as we grow. Benefits - Comprehensive health coverage, including medical, dental, and vision. - 401(k) Plan. - Paid Time Off. - Employee Assistance Program. - Health Care FSA. - Dependent Care FSA. - Health Savings Account. - Voluntary Disability Benefits. - Basic Life and AD&D Insurance. - Adoption Assistance Program. - Training and Development. - $22.00-$25.00. - And most importantly, an opportunity to make the world a better place! Company Description Wider Circle is proud to be an equal-opportunity employer that does not tolerate discrimination or harassment, of any kind. Our commitment to Diversity & Inclusion supports our ability to build diverse teams and develop inclusive work environments. We believe in empowering people and valuing their differences. We are committed to equal employment opportunity without consideration of race, color, religion, ethnicity, citizenship, political activity or affiliation, marital status, age, national origin, ancestry, disability, veteran status, sexual orientation, gender identity, gender expression, sex or gender, or any other basis protected by law.

Role Description The Physician Coder is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement. - Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation. - Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs). - Performs coding audits and quality reviews, verifying accuracy of documentation and identifying areas for provider education. - Works coding-related claim edits, holds, and scrubs in the electronic billing system (e.g., Athena Collector), ensuring timely claim resolution and reimbursement. - Collaborates with physicians, revenue cycle teams, and coding education staff, requesting clarification when necessary to ensure optimal documentation and compliance. - Performs edit checks on coded data before transmittal, identifying and correcting errors as needed. - Maintains strict confidentiality of patient records, provider information, and financial data, adhering to HIPAA and corporate compliance policies. - Escalates documentation or coding issues to the coding education team for provider training and improved documentation practices. - Assists in coding-related special projects, ensuring accurate reporting and analysis of coding data for operational improvement. - Performs other duties as assigned. - Maintains regular and reliable attendance. - Complies with all policies and standards. Qualifications - H.S. Diploma or GED required - Associate Degree in Health Information Management, Healthcare Administration, or a related field preferred - 2-4 years of experience in physician coding, professional fee coding, or medical billing required - Experience with multiple specialties, surgical coding, or high-volume professional fee coding preferred Requirements - Strong knowledge of ICD-10, CPT, and HCPCS coding systems for physician/professional fee services. - Understanding of modifier usage, place-of-service coding, and payer billing guidelines. - Experience with electronic health records (EHR), coding software, and claim processing systems. - Ability to identify documentation deficiencies and escalate for provider education. - Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements. - Strong analytical and problem-solving skills, ensuring accurate coding and optimal reimbursement. - Effective communication and collaboration skills, working with providers, revenue cycle teams, and compliance staff. Licenses and Certifications - Certified Coder-AHIMA or AAPC (CPC) required - CCS-Certified Coding Specialist (CCS-P) required - Additional certifications such as Certified Evaluation and Management Coder (CEMC) or Registered Health Information Technician (RHIT) preferred

Role Description The Inpatient/Outpatient (Coder) chooses codes from current versions of ICD CM, PCS classification systems for inpatient facility and/or professional services. Inpatient duties consist of the performance and review of documentation within the health record to assign ICD codes for: - Diagnosis - Complications/major complications - Comorbid/major comorbid conditions - Surgery - Procedures for assignment of diagnosis related groups (DRG) - Assigning CPT/HCPCS codes The technician is assigned to the Health Information Management Section, coding/analysis unit, VAMC Memphis, TN. Responsibilities include: - Selecting and assigning codes from current versions of ICD CM, PCS, and/or CPT and HCPCS classification systems. - Performing a comprehensive review of documentation within the health record. - Independently reviewing and abstracting clinical data from the record. - Coding all complicated and complex medical/specialty diseases processes, patient injuries, and all medical procedures. - Consulting with clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data. - Abstracting, assigning, and sequencing codes into encoder software. - Reviewing provider health record documentation for consistency with required medical coding nomenclature. - Querying clinical staff with documentation requirements to support the coding process. - Entering and correcting information that has been rejected. - Correcting identified data errors or inconsistencies. - Ensuring audit findings have been corrected and refiled. - Using various computer applications to abstract records, assign codes, and record and transmit data. MRT Coders may be assigned to a single facility or region, such as a consolidated coding unit. Qualifications - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English. - Certification: MRT (Coder) positions in the GS-0675 series in VHA must have either: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. - Experience and Education: - One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management. - Completion of an AHIMA approved coding program or other intense coding training program of approximately one year or more. - Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. Requirements - Skill in interpreting and adapting health information guidelines that are not completely applicable to the work or have gaps in specificity. - Ability to use judgment in completing assignments using incomplete or inadequate guidelines. - IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. - Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. Benefits - Position is remote work eligible and is exempted from return to office requirements. - Compressed/Flexible: Negotiable after hire. - Telework: ADHOC. Physical Requirements - The work is primarily sedentary. - There is walking, bending, and reaching required for filing or locating material. - Entering data and word processing on a personal computer may result in physical problems from the effects of repetitive motion and eyestrain.