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Professional Fee Coding Quality Specialist (Remote)

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Job ID: 215356
Category: Health Information Management/Coding
Work Type: FT
Location: Philadelphia, PA, United States
Work Schedule: 8hr days (remote)

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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: CORP

Department: Central Abstract Corp 

Location: Centre Square West Tower- 1500 Market Street

Hours: 8hr Days (Primarily a remote position but may require some on site work)

Summary:

  • Validate the accuracy of the professional fees abstracted from the medical record. Ensure that the clinical documentation substantiates the evaluation, management, procedure, and modifiers selected in accordance with federal, state and hospital documentation and coding requirements. Ensure documentation in the medical record supports the changes abstracted and are in compliance with organization and Medicare guidelines and regulations. Code and abstract professional fee services from patient medical records for all services as needed.

Responsibilities:

  • Validate that the appropriate ICD-10-CM diagnosis codes have been assigned in accordance with coding guidelines. Validate that appropriate CPT-4 codes for evaluation and management services and/or specified inpatient procedures have been assigned. Participate in the training process of new staff members, internal and employees of the outside contract company. Assign ICD-10-CM and CPT-4 codes to operative notes. Review the entire operative note, capture all codes, eliminate codes based on the Correct Coding Initiative (CCI) edits, and attach modifier (to ensure accurate payment), as necessary. Assist with the coding of all clinical services, both Evaluation and Management services and operative procedures, if needed for coverage purposes. Identify coding variances when the physician codes his/her own services. Identify unbillable events by the rendering or requesting physician. Neatly and accurately complete a daily production log. Meet production goals set by the Director.

Credentials:

  • CCS, CPC, or CCS-P (Required)

Education or Equivalent Experience:

  • H.S. Diploma/GED (Required)
  • And 5+ years Experience auditing professional service in an academic medical center Education Specialization:
  • Bachelor of Arts or Science (Required)
  • And 3+ years Experience coding professional services in an academic medical setting Education Specialization: HIM, Medical Coding or related field
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 and Affirmative Action 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.

   Current UPHS employees must apply HERE
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