• Responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. • Ensure coding accuracy, regulatory compliance, appropriate reimbursement, and adherence to client-specific coding guidelines, payer requirements, and industry standards. • Review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits. • Accurately assign facility Evaluation and Management (E/M) levels in accordance with client-specific emergency department leveling guidelines and facility charging methodologies, including knowledge of the ACEP tool. • Analyze documentation from nursing staff, physicians, ancillary departments, and diagnostic services to ensure complete code assignment and charge capture. • Apply official coding guidelines, CMS regulations, National Correct Coding Initiative (NCCI) edits, and payer-specific requirements. • Participate in coding quality reviews, audits, educational initiatives, and process improvement activities.

• Complete assigned development tasks using Codex, Claude, or similar AI coding tools • Work independently while following project requirements and coding standards • Ask clarifying questions early to ensure a strong understanding of assigned work • Develop, test, and troubleshoot code as needed • Participate in periodic check-ins to provide progress updates • Maintain clean, organized, and well-documented code • Identify issues and recommend solutions during development • Collaborate with the client to ensure tasks are completed accurately and efficiently

Role Description UPMC Corporate Revenue Cycle is hiring a Coder I- Profee to join our Coding Department! This position will work on Physician Coding for Anesthesia & Pain Management. This will be a work-from-home position working Monday through Friday during business hours. In this role, you will: - Assign ICD and limited CPT codes. - Review the physician documentation to determine the appropriate ICD-10 code and verify the CPT code. - Resolve basic coding edits. - Complete the charging process. - 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 the 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 complete the coding process accurately. - 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. - Graduate of an approved certified coding program preferred with a curriculum that includes Anatomy and Physiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures. - Proficient computer skills with MS Excel knowledge preferred. - In lieu of completed coding externship, 6 months experience. Licensure, Certifications, and Clearances - Act 34 Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.

Title: HIM Inpatient Coding Specialist I Job ID: 329702 Category: Health Information Management/Coding Work Type: FT Location: Philadelphia, PA, United States Work Schedule: M-F, 9-5, Remote Job Description: Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Entity: Corporate Services Department: CORP HIM Coding Location: 150 Monument Blvd Hours: M-F, 9-5, Remote *Flexible work schedule after introductory period Summary: HIM Inpatient Coding Specialist Level I Performs all coding and abstracting by reviewing medical records and selecting the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the facility is legally entitled according to stringent coding and compliance guidelines. Accountabilities - Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, co-morbidities and complications demonstrating 95% accuracy as determined by audits. - Sequences the diagnoses & procedures to obtain the optimal DRG or APR-DRG assignment and demonstrates 95% accuracy as determined by monthly audits. - Simultaneously abstracts and enters all coded information into EPIC for timely billing. This includes the correct discharge disposition verified through the CRM notes available in PennChart. - Demonstrates a consistent level of performance; strives to maintain a steady level of productivity according to the following guidelines HUP · Average of 7.5-11.5 inpatient records coded daily PPMC · Average of 7.5-11.5 inpatient records coded daily PAH · Average of 15 inpatient med/surg charts coded daily - Refers charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician for the needed documentation. - Promptly and accurately assigns Coding Hold reasons to all records that cannot be completed immediately due to: · Missing Operative Notes · Missing Pathology Report · Physician Query Needed · Death Review · Discharge Disposition · Missing Other Reports (Card Cath, EPS, etc) - Correctly identifies and applies Present on Admission indicators to all applicable diagnoses according to designated guidelines. Accuracy is important due to the far reaching impact on reimbursement and quality metrics. - Consistently codes the oldest cases first and prioritizes high dollar cases over 4 days old first. - Is willing to adjust schedule to complete workload and meet pivotal revenue cycle deadlines when requested by management. Cooperates with departmental work volumes by adjusting work schedule. - Strives to become fluent in the inpatient coding at all of the UPHS facilities. - Responsible for continuing education both inside and outside the organization along with tracking Continuing Education credits to maintain professional credentials. - Performs duties in accordance with Penn Medicine and entity values, policies, and procedures - Other duties as assigned to support the unit, department, entity, and health system organization Minimum Requirements Required Education and Experience - H.S. Diploma/GED is required. - Previous work experience or training in coding inpatient medical records is required. - Bachelor's Degree Health Information Management or a related field is preferred. Licenses, Registrations, and Certifications - Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) is preferred. - Certified Coding Specialist (CCS) is required. We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.