Experienced Professional Coding Specialist

OU Health; Town of Texas (WI); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

PTO

401(k)

Medical plan

Dental plan

Job summary

OU Health seeks an Experienced Professional Coding Specialist to independently code complex professional encounters across multiple settings, ensuring accurate E/M levels and adherence to payer policies.

You will resolve denials, participate in quality reviews, and support education to reduce denials while enjoying flexible remote/hybrid options and a competitive compensation package.

Qualifications

• High School diploma or GED is required.
• At least 3 years of physician/provider coding experience is required.
• CPC or CCS-P certification is required.

Responsibilities

• Code complex professional encounters across multiple settings with correct sequencing and modifiers.
• Resolve coding-related edits and denials by identifying root cause and supporting rebilling actions.
• Apply payer policies, NCCI concepts, and telehealth rules as relevant to professional claims.
• Provide real-time guidance to peers on standard coding scenarios and promote consistency.
• Participate in internal quality reviews and implement corrective actions based on findings.
• Review documentation in the EHR and use Epic professional coding work queues efficiently.
• Identify documentation improvement opportunities to prevent denials and support compliant query workflows.
• Work knowledge of risk adjustment concepts and HCC validation where applicable.

Skills

ICD-10-CM coding

CPT coding

HCPCS coding

E/M coding

payer policy interpretation

Education

High School diploma or GED

Tools

Epic

Encoder tools

Job description

Position Title: Experienced Professional Coding Specialist

Department: Revenue Integrity

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

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 level selection, 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 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 realtime 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

• 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

CPC or CCS-P 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.