HIM Coding & Claims Specialist - Multi-Facility

Laurel Ridge Treatment Center; Edinburg (TX); Remote; USD 70,000 - 100,000; Full time

Job summary

UHS is seeking a Coding and Claims Specialist to serve as a liaison for Texas facilities, coordinating with ATCBO, HIM, Revenue Cycle and other departments to resolve coding and claim issues. The role emphasizes real-time corrections and regulatory compliance across multiple sites.

You'll focus on Outpatient Code Editor (OCE/APC), NCCI, and medical necessity edits, while addressing DNFB resolution, audit support, and continuous process improvement through cross-department collaboration.

Qualifications

• Associates degree or higher in Health Information Management or related field; six years of coding experience may substitute.
• Coding certification required or obtained within 12 months of employment.
• High school diploma, GED or higher education required.

Responsibilities

• Serve as a liaison for Texas facilities on coding and claims issues.
• Resolve complex coding and claims problems with real-time corrections across departments.
• Focus on OCE/APC, NCCI, and medical necessity edits across facilities.
• Assist with DNFB initiatives and audit reviews; monitor reports as needed.

Skills

Excellent customer service

Health Information Management/Coding

Microsoft Office / data mining

ICD-10-CM / CPT / HCPCS / OCE/APC / N"

Medicare & Medical assistance regs

Decision-making

Communication & collaboration

Compliance awareness

Education

Associates Degree in HIM or related field

Coding experience 6 years may substitute for degree

Coding certification within 12 months

High School diploma or GED

Job description

UHS is seeking a Coding and Claims Specialist to serve as a liaison for Texas facilities, coordinating with ATCBO, HIM, Revenue Cycle and other departments to resolve coding and claim issues. The role emphasizes real-time corrections and regulatory compliance across multiple sites.

You'll focus on Outpatient Code Editor (OCE/APC), NCCI, and medical necessity edits, while addressing DNFB resolution, audit support, and continuous process improvement through cross-department collaboration.