Certified Coding Specialist I (Risk Adjustment)

%3Cp%3E%3Cmeta content=%22text/html; charset=us-ascii%22 http-equiv=%22Content-Type%22%3E%3Cstyle%3E%0Aa {%0A text-decoration: none;%0A color: #464feb;%0A}%0Atr th, tr td {%0A border: 1px solid #e6e6e6;%0A}%0Atr th {%0A background-color: #f5f5f5;%0A}%0A%3C/style%3E%3C/p%3E%3Cdiv style=%22font-family:%27Segoe UI%27;font-size:14px;font-style:normal;font-weight:400;line-height:20px;%22%3E%3Cp%3EAt UPMC Health Plan, we’re looking for a detail-oriented %3Cstrong%3ECertified Coding Specialist I%3C/strong%3E to join our Medicare HCC team. If you enjoy digging into medical records, applying your coding expertise, and making a meaningful impact on data accuracy and patient care—you’ll feel right at home here.%3C/p%3E%3Cp%3EThis is a %3Cstrong%3Efull-time, remote role%3C/strong%3E working either %3Cstrong%3E6:00 AM – 2:00 PM or 7:00 AM – 3:00 PM EST%3C/strong%3E. If you’re located in another time zone, you’ll just need to be comfortable working these Eastern Time hours.%3C/p%3E%3Cp%3E%26nbsp;%3C/p%3E%3Ch2%3EWhat You’ll Do%3C/h2%3E%3Cp%3EIn this role, you’ll play a critical part in ensuring accurate coding and documentation across a variety of care settings. On a typical day, you’ll:%3C/p%3E%3Cul%3E%3Cli%3EReview inpatient, outpatient, physician, and emergency department records to assign accurate diagnosis and procedure codes%3C/li%3E%3Cli%3EApply your expertise in %3Cstrong%3EICD-10-CM, CPT, and HCC risk adjustment coding%3C/strong%3E to ensure proper classification of diagnoses%3C/li%3E%3Cli%3EAnalyze documentation such as discharge summaries, H%26amp;Ps, progress notes, consults, and operative reports%3C/li%3E%3Cli%3EIdentify and validate diagnoses submitted through claims by comparing them against clinical documentation%3C/li%3E%3Cli%3EAudit coding for accuracy and completeness before submission—and make corrections when needed%3C/li%3E%3Cli%3EConsistently meet %3Cstrong%3Equality (95% accuracy) and productivity standards%3C/strong%3E%3C/li%3E%3Cli%3ETrack and maintain your daily coding productivity and time logs%3C/li%3E%3Cli%3EUse coding tools, systems, and resources to work efficiently and accurately%3C/li%3E%3C/ul%3E%3Ch2%3E%26nbsp;%3C/h2%3E%3Ch2%3EHow You’ll Make an Impact%3C/h2%3E%3Cp%3EYour work will directly support accurate risk adjustment and data integrity across the health plan. You’ll help ensure that diagnoses are properly captured, which ultimately supports better care planning, reporting, and outcomes.%3C/p%3E%3Cp%3E%26nbsp;%3C/p%3E%3Ch2%3EWhat Helps You Succeed%3C/h2%3E%3Cul%3E%3Cli%3EStrong knowledge of medical terminology, anatomy, physiology, and pathology%3C/li%3E%3Cli%3EConfidence working across multiple documentation types and care settings%3C/li%3E%3Cli%3EA keen eye for detail and commitment to accuracy%3C/li%3E%3Cli%3EThe ability to manage your time independently in a remote environment%3C/li%3E%3Cli%3EA proactive mindset—you’re comfortable identifying issues and helping improve processes%3C/li%3E%3C/ul%3E%3Cp%3E%26nbsp;%3C/p%3E%3Ch2%3EWhat Else to Expect%3C/h2%3E%3Cul%3E%3Cli%3EOngoing learning opportunities including coding education, seminars, and updated guidelines%3C/li%3E%3Cli%3EA collaborative team environment where your input and ideas are valued%3C/li%3E%3Cli%3EMonthly coding meetings to stay aligned and continuously improve%3C/li%3E%3Cli%3EA structured, process-driven environment with clear expectations and support%3C/li%3E%3C/ul%3E%3Cp%3E%26nbsp;%3C/p%3E%3Cp%3EIf you’re ready to bring your coding expertise to a team that values accuracy, collaboration, and continuous improvement—we’d love to hear from you.%3C/p%3E%3C/div%3E

• Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology. 
• 5 years of total experience required.
• Five for more years or risk adjustment experience highly preferred. 
• Knowledge of Microsoft Office.
  
  Licensure, Certifications, and Clearances:
   
• Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) required. 
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran