Clinic Coding Specialist

About the role

Under direct supervision, performs all medical record coding activities. Assigns appropriate diagnostic codes to patient charts and reports as assigned. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Responsibilities

• Reviews provider documentation and abstracts relevant clinical and demographic information from the medical record to accurately assign ICD-10-CM, CPT, and HCPCS codes in accordance with official coding guidelines, payer requirements, and Texas Oncology policies.
• Applies coding knowledge across surgical oncology specialties including, but not limited to, breast surgery, general surgery, colorectal surgery, gynecologic oncology, urologic oncology, thoracic surgery, and related clinic services.
• Assigns diagnoses and procedures accurately and consistently while maintaining established productivity and quality standards.
• Reviews documentation to determine code assignment, sequencing, medical necessity support, modifier application, and compliance with payer-specific reimbursement requirements.
• Identifies documentation deficiencies and collaborates with providers and leadership to obtain clarification when documentation is incomplete, conflicting, or insufficient to support code assignment.
• Demonstrates knowledge of Evaluation and Management (E/M) coding guidelines and documentation requirements, while recognizing that providers are ultimately responsible for level selection when applicable.
• Researches coding, reimbursement, and regulatory questions using coding references, payer policies, National Correct Coding Initiative (NCCI) edits, Medicare guidance, and other approved resources.
• Assists with denial prevention and revenue integrity efforts by identifying coding trends, documentation opportunities, and reimbursement issues that may impact claim accuracy or payment.
• Maintains current knowledge of coding changes, payer updates, compliance regulations, and specialty-specific documentation requirements through ongoing education and training.
• Participates in coding audits, quality reviews, provider education, and process improvement initiatives to support coding accuracy, compliance, and operational efficiency.
• Collaborates effectively with providers, clinical staff, revenue cycle teams, and other departments to ensure accurate charge capture, coding, and reimbursement.
• Maintains the confidentiality, security, and integrity of protected health information in accordance with HIPAA, organizational policies, and applicable regulations.

Minimum quality expectations

• Achieves and maintains established coding quality standards as measured through internal quality assurance reviews.
• Meets productivity expectations for assigned specialty and work queue.
• Demonstrates proficiency in specialty-specific coding, modifier usage, documentation requirements, and payer guidelines.
• Works independently while escalating complex coding, compliance, or reimbursement issues as appropriate.

Qualifications

Level 1

• High school diploma or equivalent required.
• Completion of a course in medical record technology.
• Minimum one year of coding medical experience required, three years experience medical coding preferred.
• Applicable certification preferred.
• Knowledge of medical records coding procedures and knowledge of ICD-9 and CPT-4 Coding Systems highly desirable.

Level Sr (in addition to Level 1 requirements)

• Completion of a course in Medical Terminology
• Minimum five years medical coding experience, prior oncology experience preferred.
• Certification as RHIT preferred.

Schedule

This full time hybrid remote position will support our Central Business Office at 3001 E President George Bush Hwy Richardson, TX 75082. This position will work Monday - Friday and also requires the candidate to live in the state of Texas.

Physical demands

• While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel.
• The employee is occasionally required to stand, walk, and reach with hands and arms.
• The employee must occasionally lift and/or move up to 30 pounds.
• Requires vision and hearing corrected to normal ranges.

Work environment

Work is performed in an office environment.