Experienced Professional Coding Specialist

OU Health; Texas; Hybrid; USD 75,000 - 110,000; Full time

Benefits offered by this job

Comprehensive benefits package

PTO and 401(k)

Medical and dental plans

Job summary

OU Health in Texas is seeking an Experienced Professional Coding Specialist to independently perform advanced professional coding across multiple settings, including office, hospital outpatient, ED, ASC, SNF, and telehealth. You will apply coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement and audit defensibility.

You will resolve denials, support rebilling actions, and participate in internal quality reviews while mentoring peers and

Qualifications

• 3+ years of physician/provider coding experience.

Responsibilities

• Code complex professional encounters and procedures with correct sequencing, modifiers, and E/M levels.
• Resolve coding-related edits and denials by identifying root cause and coordinating documentation clarification.
• Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules.
• Provide real-time guidance to peers on standard coding scenarios to promote consistency.

Skills

ICD-10-CM coding

CPT coding

HCPCS coding

Modifier usage

E/M coding

Education

High School diploma or GED

Tools

Epic professional coding

Encoder tools

Job description

Position Title:Experienced Professional Coding SpecialistDepartment:Revenue IntegrityJob 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 Description

Independently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth.Appliesadvanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement,wRVUintegrity, 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 levelselection, and documentation alignment.Advanced expertise in ICD10CM, CPT, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.
• Resolve coding-related edits and denials byidentifyingroot 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.
• Providerealtime guidance to peers on standard coding scenarios; promote consistency through bestpractice sharing.
• Participate in internal quality review programs and implement education/corrective actions based on findings.
• Proficiencyin Epic professional codingwork queuesand encoder tools; ability to efficiently review documentation in the EHR across settings.
• Analytical problem solving for denial/edits prevention; abilitytoidentifydocumentation improvement opportunities and support compliant query workflows
• Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations.

General Job Duties

• Performs other duties as assigned

Education

High School diploma or GED required.

Experience

At least 3 years of experience physician/provider coding required.

Certification/License/Registration

RHIA, RHIT, CCS, CPC, or CIC required.

We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more.

OU Health is an equal opportunity employer.

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.