Coding Quality Assurance Specialist III

Texas Children's Hospital; Houston (TX); On-site; USD 60,000 - 80,000; Full time

Job summary

Texas Children's Hospital is seeking a Coding Quality Assurance Specialist III to ensure the accuracy of coding practices and support billing and regulatory reporting. The ideal candidate will have experience in coding, relevant certifications, and a commitment to quality care in a pediatric setting.

Qualifications

• Certifications in coding (CCA, CCS, etc.) from recognized bodies.
• 4+ years of coding experience, preferably with electronic medical records.
• Inpatient coding experience is highly desirable.

Responsibilities

• Assign and audit ICD-10-CM and CPT codes for various medical records.
• Review physician documentation to ensure accurate coding.
• Provide feedback to education team based on auditing results.

Skills

Coding accuracy

Attention to detail

Communication skills

Education

High School Diploma or equivalent

Job description

Position: Coding Quality Assurance Specialist III

Talent Area: Administrative Support

Full/Part Time: Full time

Location: Houston, TX, US

Shift: 8a-5p Monday-Friday

Job ID: 418511

We’re looking for a Coding Quality Assurance Specialist III, someone who’s ready to grow with our company. In this position, you will assign and audit the accuracy of ICD-10-CM and CPT codes for ambulatory, emergency center, observation, and day surgery records, supporting billing, research, and regulatory reporting. You will verify the accuracy of physicians' E/M and procedure coding based on documentation, complete auditing reports, and provide feedback to the education team and/or providers. Responsibilities may vary depending on work assignment.

Think you’ve got what it takes?

Job Duties & Responsibilities

1. Assign ICD-10-CM, ICD-10-PCS, DRG, E/M, and/or CPT codes.
2. Review and interpret physician documentation to assign diagnosis and procedure codes accurately.
3. Communicate findings and provide feedback to the education team and/or providers.
4. Review patient charges to determine necessary coding for account completion.
5. Identify principal and secondary diagnoses and procedure codes from electronic medical records.
6. Use coding tools (encoder, coding books) to generate appropriate codes.
7. Sequence diagnoses and procedures for correct billing.
8. Query physicians for clarification when diagnoses are not clearly documented.
9. Utilize available resources (e.g., Epic, MIQS, Cardio IMS, coding references) for code assignment.
10. Assist colleagues in resolving coding issues.
11. Provide ICD-10 and CPT codes for research and quality reporting.
12. Complete record abstracts as needed.
13. Support correction of problematic accounts.
14. Review charts for completeness.
15. Participate in ongoing education and maintain certification.
16. Assist in auditing records and maintaining concurrent inpatient coding.

Skills & Requirements

• High School Diploma or equivalent.
• Certifications such as CCA, CCS, CCS-P, CIPC, COC, CPC, CRC, RHIA, or RHIT from recognized bodies (AAPC or AHIMA).
• At least 4 years of coding experience, preferably with experience using encoders and electronic medical records.
• Previous inpatient coding experience is highly desirable.

About Texas Children’s

Since 1954, Texas Children’s has led in patient care, education, and research to improve children’s and women’s health worldwide. Our facilities include a primary hospital in the Texas Medical Center, the Jan and Dan Duncan Neurological Research Institute, and other specialized centers. We also have a comprehensive health care network, including Texas Children’s Health Plan, pediatric primary care, urgent care clinics, and international health programs. Texas Children’s is affiliated with Baylor College of Medicine and is proud to be an equal opportunity employer.