UPMC Senior Communities

UPMC Corporate Revenue Cycle is hiring a Coder I- Profee to join our Coding Department! This position will work on denials for all specialties. 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. Coders review the physician documentation to determine the appropriate ICD-10 code and verify the CPT code, but in some cases assign basic CPT codes. Resolve basic coding edits. Complete the charging process. Ensure diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered- requires knowledge of billing and coding guidelines. 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...

Purpose: Same responsibilities as a Coder I. Review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, determine level of acuity, procudure(s) performed, billable supplies and diagnosis to substantiate medical necessity. Review and sequence all codes to to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution. Responsibilities: 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...

Three Rivers Orthopedics is seeking a Certified Specialty Coder to support 11 orthopedic surgeons specializing in areas including spine and foot/ankle at 200 Delafield Road, Suite 1040, Pittsburgh, PA 15215. This full-time position runs Monday-Friday, 8:00 AM-4:30 PM, with flexible hours and work from home option. Responsibilities: Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements. Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. Perform all coding functions, based on staffing needs and/or department requirements. Refer problem accounts to appropriate coding or management personnel for resolution. Maintain daily...

Purpose: Codes Ancillary outpatient accounts, diagnosis coding only. Codes Ancillary Service patient type (single visit service such as lab, x-ray, pathology specimen); requires ICD-9 diagnosis coding skills only. Coder reviews the physician script, order or chief complaint as documented in a diagnostic report to determine the appropriate ICD-9 code. Ensures diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered- requires knowledge of billing and coding guidelines. Respond to Cirius errors identified by coder ID # on the daily report. Responsibilities: Refer problem accounts to appropriate coding or management personnel for resolution. Meet appropriate coding productivity and quality standards within the time frame established by management staff. 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...