Experienced Professional Coding Specialist

OU Health; United States; Hybride; USD 70 000 - 100 000; Plein temps

Avantages offerts par ce poste

PTO

401(k)

Medical and dental plans

Résumé du poste

OU Health is seeking an experienced Professional Medical Coder to independently perform complex professional coding across multiple settings including office, hospital outpatient, ED/urgent care, ASC, SNF, and telehealth. You will apply ICD-10-CM, CPT, HCPCS coding rules with advanced E/M expertise to ensure compliant reimbursement and audit defensibility.

The role supports a remote/hybrid work model with ongoing professional development and competitive compensation.

Qualifications

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

Responsabilités

• Code complex professional encounters across settings (office, hospital outpatient, ED/urgent care, ASC, SNF, telehealth).
• Resolve coding edits and denials; rebilling actions as needed.
• Apply payer policies, NCCI concepts, and telehealth rules for professional claims.
• Provide real-time guidance to peers on coding scenarios.
• Participate in internal quality reviews and education actions.
• Review documentation efficiently in EHR and related tools.
• Understand risk adjustment concepts and HCC validation where applicable.

Connaissances

Advanced coding proficiency

Payer policy interpretation

Documentation standards

Epic professional coding workflows

E/M coding

ICD-10-CM

CPT

HCPCS

Formation

High School diploma or GED

Outils

Epic

Encoder tools

Description du poste

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 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, 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 levelselection, 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 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.
• 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.
• Proficiencyin Epic professional codingwork queuesand encoder tools; ability to efficiently review documentation in the EHR across settings.
• Analytical problem solving for denial/edits prevention; ability toidentifydocumentation 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.