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Certified Coding Specialist I- Health Plan- Remote

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<strong>UPMC Health Plan has an exciting opportunity for a Certified Coding Specialist I position in the Medicare HCC department. This is a full time position working Monday through Friday daylight hours. This is a remote position. <br><br></strong>Ability to code using ICD-10-CM and appropriately assigning diagnosis and procedure codes after reviewing all documentation available. Performs audits to determine accuracy of code selection. Responsible for validating diagnoses submitted via claims to the Health Plan by reviewing inpatient, outpatient, and provider office documentation.<br><br><strong>Responsibilities:<br><br></strong><ul><li>Code Inpatient, Outpatient, physician, and ED charts as necessary. </li><li>Assign Risk Adjustment HCC diagnoses by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology, and pathology. </li><li>Review the discharge summary, history and physical, physician progress notes, consultation reports, operative records, emergency room record to accurately assign a diagnosis and / or procedure. </li><li>Review appropriate documents to accurately assign a Risk Adjustment HCC diagnosis. </li><li>Review coding for accuracy and completeness prior to submission. </li><li>Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD-10-CM and CPT codes. </li><li>Utilize computer applications and resources essential to completing the coding process efficiently. </li><li>Responsible for correcting any data found to be in error after reviewing the medical record and comparing with system entries. </li><li>Complete work assignments in a timely manner. </li><li>Meet coding accuracy standards of 95% as well as coding productivity standards. </li><li>Complete coder productivity and time log daily. </li><li>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. </li><li>Performs in accordance with system-wide competencies/behaviors. </li><li>Performs other duties as assigned. </li><li>Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology. </li><li>5 years of total experience. </li><li>Knowledge of Microsoft Office. <br><br></li></ul><strong>Licensure, Certifications, and Clearances:<br><br></strong>Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) required. <br><br><ul><li>Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC)<br><br></li></ul><strong>UPMC is an Equal Opportunity Employer/Disability/Veteran</strong>

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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