Senior Professional Fee Coder

Baylor College of Medicine; United States; Hybrid; USD 63.000 - 85.000; Vollzeit

Zusammenfassung

Baylor College of Medicine seeks a Senior Professional Fee Coder to assign ICD-10-CM and CPT codes to physician services based on clinical documentation. The role reviews records, resolves edits, and supports compliant submission to maximize reimbursement.

Located in Houston, TX with a hybrid work arrangement, the coder collaborates with physicians and billing teams, ensures compliance with payer policies, and supports the revenue cycle and financial integrity of the Faculty Group Practice.

Qualifikationen

• High school diploma or GED is required.
• Five years of relevant experience.
• Certified Coding Specialist – Physician-based (CCS-P) by AHIMA or CPC by AAPC.

Aufgaben

• Assign ICD-10-CM, CPT, and HCPCS codes to professional services.
• Review physician documentation, operative reports and notes to accurately assign codes.
• Ensure coding reflects services performed and supports medical necessity while complying with regulations.
• Code a variety of services across multiple specialties including E/M.

Jobbeschreibung

Senior Professional Fee Coder

Division: Patient Business Services

Work Arrangement: Hybrid

Location: Houston, TX

Salary Range: $63,052 to $84,762

FLSA Status: Nonexempt

Work Schedule: Monday – Friday, 8 a.m. – 5 p.m.

Job Summary

The Senior Professional Fee Coder is responsible for ensuring accurate and timely coding of physician and professional services by assigning appropriate ICD-10-CM and CPT codes based on clinical documentation. This role reviews medical records, resolves coding edits and charge discrepancies, and helps ensure compliant claim submission to maximize reimbursement. The coder collaborates with physicians, clinical staff, and billing teams to provide coding guidance, support revenue cycle operations, and maintain compliance with coding regulations and organizational policies. Through detailed documentation review and reconciliation of charges, this position plays a key role in the financial integrity of the organization. The Senior Professional Fee Coder serves as a subject matter expert responsible for accurate coding, charge capture, and revenue cycle support for physician professional services across multiple clinical specialties. This position ensures compliance with federal regulations, payer policies, and institutional guidelines while supporting the financial performance of the Faculty Group Practice. This position is located at Greenway Plaza with opportunities to work on site and remotely.

Job Duties

Assigns ICD-10-CM, CPT, and HCPCS codes to professional services.

Reviews physician documentation, operative reports, procedure notes, clinic encounters, and ancillary reports to accurately assign diagnosis and procedure codes in accordance with current ICD-10-CM, CPT, HCPCS Level II, and payer-specific guidelines.

Ensures coding accurately reflects the services performed and supports medical necessity while maintaining compliance with federal regulations, National Correct Coding Initiative (NCCI) edits, and Medicare guidelines.

Codes a variety of surgical and evaluation and management (E/M) services across multiple specialties.

Reviews and abstracts medical record documentation.

Analyzes complex medical records to ensure complete and accurate charge capture.

Interprets operative reports and physician documentation to determine the appropriate coding and sequencing of diagnoses and procedures.

Identifies documentation deficiencies and communicate with providers when clarification is required to support accurate coding and billing.

Performs charge reconciliation and resolve billing edits.

Reviews daily work queues to identify missing charges, coding edits, claim rejections, and billing exceptions prior to claim submission.

Researches and resolves charge discrepancies using the electronic health record (Epic), Optum Claims Manager, encoder software, payer policies, and departmental billing systems.

Ensures charges are submitted accurately and within established productivity and timeliness standards to minimize claim delays and maximum_reimbursement.

Performs other job-related duties as assigned.

Minimum Qualifications

High school diploma or GED.

Five years of relevant experience.

Certified Coding Specialist – Physician-based (CCS-P) by the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).

Work Authorization Requirement: This position is not eligible for visa sponsorship. Candidates must be legally authorized to work in the United States at the time of application and throughout the duration of employment.

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.