• Review home health and hospice clinical documentation across all time points (SOC, ROC, Recertification, Transfer, Discharge, Admission) to assign accurate ICD-10-CM diagnosis codes. • Sequence diagnoses in strict compliance with ICD-10-CM guidelines, CMS requirements, PDGM payment methodologies, and hospice coding expectations. • Audit clinical charts to identify documentation gaps or inconsistencies, and collaborate with clinical leadership or compliance teams to resolve query needs. • Support revenue cycle efficiency by meeting established productivity and turnaround time goals to prevent delays in billing and claim submissions. • Assist with internal quality assurance and external medical reviews, including TPE, ADRs, and compliance audits. • Collaborate cross-functionally with clinical, QA, compliance, and revenue cycle teams to drive documentation integrity and regulatory readiness.

Role Description UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. As the Coder II, you will: - Review all pertinent physician, nursing, and ancillary documentation. - Determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. - Review and sequence all codes to maximize reimbursement and address any potential bundling issues. - Handle LMRP/CCI edit and coding denial resolution. Responsibilities include: - Utilize computer applications and resources essential to completing the coding process efficiently. - Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff. - Refer problem accounts to appropriate coding or management personnel for resolution. - 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. - Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement. - Make forward progress toward meeting coding accuracy standards within the first year of employment. - Utilize standard coding guidelines, principles, and coding clinics to assign the appropriate ICD and CPT codes for all record types. - Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. - 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. - 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. Qualifications - High school graduate or equivalent. - In lieu of 2 years of coding experience with schooling, a minimum of 3 years experience or CPC certification required. - Graduate of an approved certified coding program preferred with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures. - Proficient computer skills with MS Excel knowledge preferred. - General Surgery coding experience is preferred. Requirements - Eligible for CPC or CPC specialty certification. - Act 34 clearance. Benefits - UPMC is an Equal Opportunity Employer/Disability/Veteran.

Role Description The Health Administration Service is seeking a full-time Medical Records Technician (Coder-Inpatient) for the Ralph H. Johnson VA Medical Center in Charleston, South Carolina. This is a remote position. This position is located in the Health Information Management (HIM) section of the Health Administration Service (HAS) at the Ralph H. Johnson VA Health Care System. MRTs (Coder) are skilled in classifying medical data from patient health records in various settings. Typical duties include, but are not limited to: - Selecting and assigning codes from ICD, CPT, and/or HCPCS for patient care encounters. - Adhering to accepted coding practices and guidelines for accurate coding. - Monitoring regulatory and policy requirements affecting coded information. - Performing comprehensive reviews of electronic health records to abstract necessary data. - Assisting facility staff with documentation requirements and providing technical support. - Searching patient health records to justify code assignments. - Identifying principal diagnoses and procedures for inpatient discharges. - Conducting reviews of codes abstracted for inpatient encounters as per VERA requirements. - Coding inpatient professional fee services based on compliance with guidelines. Work Schedule: Monday - Friday, 8:00am - 4:30pm Qualifications - Three years of inpatient coding experience with proficiency in ICD-10-CM/PCS guidelines. - Strong understanding of inpatient reimbursement methodologies and coding compliance standards. - Ability to work independently with a high degree of accuracy. Requirements - United States Citizenship. - Proficiency in spoken and written English. - One year of creditable experience in medical terminology, anatomy, physiology, and medical coding. - Associate's degree in health information technology or related field, or completion of an AHIMA approved coding program. - Certification through AHIMA or AAPC. Benefits - Competitive salary and regular salary increases. - 37-50 days of annual paid time off per year. - Up to 12 weeks of paid parental leave after 12 months of employment. - Child care subsidy for eligible employees after 60 days of employment. - Traditional federal pension and federal 401K with contributions by VA. - Federal health/vision/dental/term life/long-term care insurance options.

Role Description The role of the remote Revenue Cycle Coder is crucial to the revenue cycle team. The team connects with our patients, their insurers or bill payers and our physicians. Accuracy and efficiency of this team directly impacts our mission to be the leader in physician-managed healthcare services and to provide excellent surgical and clinical care for every patient, every day. The Revenue Cycle Coder is critical to maintaining the funding for our services provided. CPC is required Schedule: Full-time, Monday - Friday. Hours are roughly 8am - 5pm. Key Duties and Responsibilities - Reviews/audits and interprets medical record documentation to identify pertinent diagnosis/procedure and apply correct ICD10, CPT-4, and HCPC’s codes in accordance with government and insurance regulations. - Demonstrates appropriate utilization of coding software and coding reference material. - Follow up with providers on any documentation that is insufficient, missing, or unclear. - Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders. - Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines. - Reviews and resolves suspended charges due to claim edits or payor rejections related to coding. - Reviews, corrects and appeals coding-related denials trends and shares with leadership, and team members to facilitate root cause analysis and continuous process improvement. - Corrects and/or appeals denied claims due to coding errors. - Other duties as assigned. Qualifications - Minimum 3 years coding/medical billing experience. - Professional coder certification with credentialing from AHIMA and/or AAPC, must be maintained annually. - ICD10 certified and/or extensive work experience. Requirements - A strong understanding of physiology, medical terms, and anatomy. - Thorough attention to detail. - Excellent written and verbal communication skills. - Self-motivated team player able to multi-task and prioritize. - Excellent organization and interpersonal communication skills. - Strong computer skills. - Strong computer skills/experience with Microsoft Excel, Outlook, and Adobe. - Working experience navigating EHR’s to abstract documentation. Work Environment/Physical Demands The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions. - Work may be performed in an office and clinical environment. - Requires corrected vision and hearing to normal range. - While performing the duties of this job, the associate is regularly required to talk or hear. - The associate is required to sit for long periods of time, stand and walk, bend and stretch. - Use of telephone and computer is required. - Manual dexterity required for use of computer keyboard. - Occasionally lifts and carries items weighing up to 40 pounds. - May require working under stressful conditions or working irregular hours.