Experienced Professional Coding Specialist

OU Health; New York (NY); Remote; USD 85,000 - 115,000; Full time

Job summary

OU Health in Revenue Integrity is seeking an Experienced Professional Coding Specialist to perform complex professional coding across office, hospital outpatient, ED, ASC, SNF, and telehealth. You will apply ICD-10-CM, CPT, and HCPCS with strong E/M judgment to support compliant reimbursement and audit readiness.

This role offers flexible remote/hybrid options, ongoing career development, and a competitive compensation package.

Qualifications

• High school diploma or GED required.
• At least 3 years of physician/provider coding experience.
• RHIA, RHIT, CCS, CPC, or CIC certification required.

Responsibilities

• Code complex professional encounters and ensure correct sequencing, modifiers, E/M level, and documentation alignment.
• Resolve coding-related denials by identifying root cause and supporting rebilling actions.
• Apply payer policies, NCCI concepts, and global service considerations to professional fee claims.
• Provide real-time guidance to peers and promote best-practice sharing.
• Participate in internal quality reviews and implement corrective actions based on findings.
• Review documentation across settings in the EHR (Epic) and encoder tools.

Skills

Medical coding

ICD-10-CM

CPT/HCPCS coding

Payer policy interpretation

Epic EHR

Education

High School Diploma or GED

Tools

Epic Encoder Tools

Job description

Position Title

Experienced Professional Coding Specialist

Department

Revenue Integrity

Job Description

!Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.

Please do not apply if you reside outside these 5 states and will not relocate to one of the approved states listed.

Join a forward-thinking team where your expertise drives quality patient care! We are looking for a detail-oriented Professional Medical Coder to help streamline our charge review coding workflow for Adult and Pediatric Evaluation and Management services and Minor Procedures, resolve denials and work with leadership to put processes in place to reduce denials. Enjoy flexible remote / hybrid options, continuous career development, and competitive compensation in a supportive environment.

General DescriptionIndependently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.

Essential Job Duties

• Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.
• Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment.
• Advanced expertise in ICD‑10‑CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.
• Resolve coding-related edits and denials by identifying root cause, coordinating documentation clarification, and supporting rebilling actions as applicable.
• Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules as relevant to pro fee claims.
• Provide real‑time guidance to peers on standard coding scenarios; promote consistency through best‑practice sharing.
• Participate in internal quality review programs and implement education/corrective actions based on findings.
• Proficiency in Epic professional coding work queues and encoder tools; ability to efficiently review documentation in the EHR across settings.
• Analytical problem solving for denial/edits prevention; ability to identify documentation improvement opportunities and support compliant query workflows.
• Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations.

General Job Duties

General Job DutiesPerforms other duties as assignedEducation:

Education

High School diploma or GED required.Experience:

Experience

At least 3 years of experience physician/provider coding required.Certification/License/Registration : RHIA, RHIT, CCS, CPC, or CIC required.

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.