Coder II

HHM Health; Dallas (TX); On-site; USD 39,000 - 45,000; Full time

Benefits offered by this job

Health insurance

Vision & dental

403(b) retirement with match

Paid time off & holidays

Disability coverage

Employee assistance program

Job summary

HHM Health in Dallas, TX seeks a Coder II to support billing across Texas Medicaid, MCOs, Medicare, and commercial payers. The coder reviews provider documentation and assigns accurate CPT, HCPCS, and ICD-10-CM codes for outpatient services, ensuring revenue integrity and compliant billing.

Ideal candidate has 3+ years in outpatient coding, CPC or CCS-P certification, and strong knowledge of E/M rules, NCCI edits, and denials management. EHR/PM experience including eClinicalWorks is required.

Qualifications

• Active CPC (AAPC) or CCS-P (AHIMA) certification.
• At least 3 years of outpatient professional fee coding experience.
• Strong command of E/M leveling, modifiers, and NCCI edits.
• Working knowledge of Texas Medicaid, MCO rules, and Medicare payers.
• Experience handling denials and understanding EOBs/ERAs.
• Proficiency with EHR and practice management systems.
• Ability to meet productivity targets with 95%+ accuracy.
• FQHC or community health center coding experience, PPS/encounter billing.

Responsibilities

• Code outpatient professional encounters using CPT, HCPCS Level II, and ICD-10-CM guidelines.
• Identify qualifying visits for FQHC encounters and apply PPS logic by payer.
• Review claim edits and pre-bill scrubs to correct coding errors before submission.
• Resolve coding-related denials from TMHP, MCOs, Medicare, and payers with documentation.
• Query providers to resolve documentation gaps while following compliant practices.
• Participate in internal coding audits and educate providers and staff.
• Keep up with CMS/TMHP/TMPPM and MCO policy updates.
• Maintain HIPAA confidentiality and HHM’s compliance program.

Skills

Outpatient coding

EM coding knowledge

NCCI edits

Denials handling

EHR/PM proficiency

Education

CPC or CCS-P certification

Tools

eClinicalWorks

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Coder II

Billing Full Time Dallas, TX, US

Salary Range: $28.00 To $33.00 Hourly

At HHM Health, our mission is to provide high quality and compassionate healthcare to all. Our vision is to be the best patient-focused health center providing personalized physical, mental, and spiritual care for every individual. We are led by our CARES Values (Compassion, Advocacy, Respect, Excellence, Servant Heart). Together, our CARES-givers are making a difference in Dallas and surrounding communities.

The Opportunity

HHM Health is seekinga Coder II to support billing across Texas Medicaid, Medicaid/CHIP managed care organizations, Medicare, and commercial payers. The Medical Coder reviews provider documentation and assigns accurate CPT, HCPCS, and ICD-10-CM codes for outpatient professional services. This role requires hands-on experience coding professional (CMS 1500/837P) claims in an ambulatory setting. The coder protects revenue integrity and compliance by making sure every encounter is coded to the documentation and billed correctly for its payer.

How You Will Make an Impact :

• Code outpatient professional encounters using current CPT, HCPCS Level II, and ICD-10-CM guidelines, including 2021+ E/M office visit rules (MDM and time-based).
• Support FQHC encounter billing: identify qualifying visits, apply the correct encounter/T1015 and PPS logic by payer, and flag non-billable or incident-to services.
• Review claim edits, NCCI conflicts, and pre-bill scrubber rejections, and correct coding errors before submission.
• Research and resolve coding-related denials from TMHP, MCOs, Medicare, and commercial payers, and support appeals with documentation.
• Query providers when documentation is incomplete, conflicting, or doesn't support the level of service, following compliant query practices.
• Take part in internal coding audits and give feedback and education to providers and staff.
• Keep up with CMS, TMHP, Texas Medicaid Provider Procedures Manual (TMPPM), and MCO policy updates.
• Maintain HIPAA confidentiality and follow HHM's compliance program.
• Conduct regular retrospective and prospective reviews by provider to identify services performed and documented but not coded or billed.
• Analyze E/M level distribution by provider against peer and CMS benchmarks, and flag patterns of under coding (e.g., defaulting to 99213 when MDM or time supports 99214).
• Flag billable care management and integrated services not being captured (e.g., chronic care management, behavioral health integration) according to FQHC payer rules.
• Track and report missed-opportunity findings monthly, with estimated revenue impact by provider, service line, and payer.
• Deliver one-on-one and group provider education on documentation and coding.
• Recommend EHR template, smart phrase, and charge-capture workflow improvements to prevent recurring misses.
• Re-audit providers after education to measure improvement and report results to the Director of Revenue and Billing.

What you need to succeed

• Active certification: CPC (AAPC) or CCS-P (AHIMA).
• At least 3 years of outpatient professional fee coding experience in a physician practice, clinic, or FQHC setting.
• Strong command of E/M leveling, modifier usage, and NCCI edits.
• Working knowledge of Texas Medicaid, Medicaid MCO billing rules, commercial and Medicare payers.
• Experience working denials and understanding EOBs/ERAs.
• Proficiency with EHR and practice management systems.
• Ability to meet productivity targets while holding accuracy at 95% or higher
• FQHC or community health center coding experience, including PPS/encounter billing and sliding fee discount program familiarity.
• OB/GYN and/or pediatric specialty coding experience.
• THSteps and Healthy Texas Women billing experience.
• CRC or CPB certification.
• Experience with eClinicalWorks.

Why HHM Health

At HHM Health, our mission starts with caring for people. We believe that when our team feels supported, valued, and healthy, they can make the greatest impact on the communities we serve. Our Executive Leaders receive a robust total rewards package designed to empower them to thrive at work, at home, and in their purpose so they can focus on what matters most: influencing strategy, shaping standards of care, developing talented clinicians, and helping ensure that high-quality services reach the people who need them.

That’s why we invest in our employees’ well-being with free vision, dental, and basic life insurance, plus competitive medical premiums. We also offer the following:

• Health Reimbursement, Health Savings Account and Flexible Savings Account
• 403(b) retirement savings plan with dollar-for-dollar matching up to 3% and match 50% of the next 2% (contribute 5% to get 4% matched). 100% vested upon enrollment!
• Generous paid time off program including Health & Wellness Days and Volunteer Days
• Paid Holidays
• Accidental Death & Dismemberments (ADD) plan
• Short-term &Long-term Disability
• Employee Assistance Programs (EAP)
• Critical Illness Plan, Hospital Indemnity Plan, and Accident plans at no cost
• HHM CARES Fund (employee emergency relief fund)

Equal Opportunity Employer

HHM Health is committed to providing equal employment opportunity to all individuals regardless of their race, color, religion, gender identity and expression, age, sexual orientation, national origin, disability, veteran status, marital status, or any other characteristic protected by federal, state or local law. HHM Health hires and promotes based solely on the qualifications of the individual and the essential functions of the job being filled .