Professional Coder II- Revenue Cycle

Position Summary

The Professional Coder II is responsible for reviewing medical documentation provided by physicians or other health care professionals to validate or assign and sequence CPT/HCPCS, ICD-10CM, and modifiers for both clinic and hospital based professional encounters. The Coder applies coding conventions in accordance with official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for inpatient/outpatient E/M encounters including office or hospital outpatient procedures, radiology and emergency department visits.

Department & Location Details

Department: Revenue Cycle
Status: Full-time
Location: Remote (2 weeks onsite for training @ 1851 Crosspoint Ave, 77054)
Must live in Texas and can attend required onsite trainings and meetings. We do not provide lodging or mileage reimbursement for onsite trainings or meetings.

Key Accountabilities

• Resolves edits and assigns diagnosis and procedure codes.
• Responsible for reviewing encounters in the coding work queue in a timely manner and resolving all coding related edits.
• Reviews medical record and accurately assigns and sequences CPT, ICD-10CM, and HCPCS codes/modifiers ensuring compliance with all applicable guidelines.
• Approves and assigns ICD-10 and CPT codes suggested within Code Ryte CAC application for Radiology and Emergency Medicine services.
• Reviews and assigns ICD-10 and CPT codes for office and hospital EM services including Critical Care, bed side and other less complex procedures.
• Generates basic physician queries in accordance to established procedures.
• Provides feedback and education as required.
• Confirms that all applicable UTHealth and Coding Guidelines are being followed when resolving edits.
• Performs charge entry of professional services including but not limited to non-invasive tests, anesthesia, hospital or office-based visits.
• Abstracts information needed for billing of ancillary procedures or other outpatient services.
• Resolves any applicable system errors during charge entry.
• Performs charge reconciliation when applicable to the department via logs, visit schedules, and other reports.
• Meets the required coding quality and productivity expectations per department policy and procedure.
• Completes all education assigned by the Charge Capture and Coding department in collaboration with Clinical Documentation Improvement (CDI).
• Stays up-to-date with all federal, state, coding & departmental guidelines and procedures.
• Performs other duties as assigned.

Certification Requirements

• Registered Health Information Administrator (RHIA) by American Health Information Management Association (AHIMA) required or
• Registered Health Information Technician (RHIT) by American Health Information Management Association (AHIMA) required or
• Certified Coding Specialist (CCS) by American Health Information Management Association (AHIMA) required or
• Certified Coding Specialist Physician-based (CCS-P) by American Health Information Management Association (AHIMA) required or
• Certified Professional Coder (CPC) by American Academy of Professional Coders (AAPC) required or
• Radiology Coding Certification (RCC) by Radiology Coding Certification Board (RCCB) required

Required Skills

• Analytical skills, ability to interpret data, and maintain spreadsheets.
• Knowledge of ICD-10 CM and CPT coding conventions.
• Proficiency in Microsoft Office suite, the ability to abstract data and maintain a database required.
• High level understanding of all federal/government regulations, coding guidance and the revenue cycle policies and procedures.
• Effective verbal and written communication between internal and external customers.
• Excellent time management skills required.
• Self-motivated and able to work independently without close supervision.
• Ability to work effectively under pressure due to changing priorities, interruptions, and workload variability.

Minimum Education

High School Diploma or equivalent required.

Minimum Experience

3 years experience in Health Information Management (HIM) coding required.
Clinic or hospital E/M coding preferred.
Clinic and hospital outpatient-based procedures preferred.
May substitute required experience with equivalent years of education beyond the minimum education requirement.

Preferred Experience

Cardio, Emergency, and Gastro coding experience and familiarity with Epic are a plus.

Physical Requirements

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Residency Requirement

Employees must permanently reside and work in the State of Texas.