Senior Coding Specialist Telecommute - Reside in TX

Senior Coding Specialist – Houston Methodist

Come lead with us at Houston Methodist Primary Care Group. Telecommute – Must reside in TX.

• Non‑exempt

• High School diploma or equivalent (e.g., GED, homeschool equivalency, or partial completion of post‑secondary education).

• Five years of professional coding experience.

• Must have one of the following:
  • CCS – Certified Coding Specialist (AHIMA)
  • CPC – Certified Professional Coder (AAPC)

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations.
• Proficiency in speaking, reading, and writing English sufficient for essential functions.
• Effective communication with patients, physicians, family members, and coworkers, maintaining a customer‑service focus.
• Knowledge of ICD‑9, ICD‑…but…”

• Communicates regularly with physicians and PO CBO staff to clarify accurate coding of diagnoses and procedures.
• Collaborates with management on coding and diagnosis issues to reduce claim denials through verbal and written communication.
• Assists with knowledge sharing, training Coding Specialists, and department cross‑training; provides support to other team members as advised by the manager and/or supervisor.

• Responds to or clarifies internal requests from all business partners for medical coding information in a timely manner.
• Participates in coding round tables and in‑services for continuing education.
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• Codes and abstracts medical records for reimbursement purposes from patient charts, physician documentation, and diagnostic or interventional reports using current coding conventions and 3M encoder tools.
• Reviews medical records to verify and substantiate diagnoses and procedures for charge review, claim edits, or denied claims and submits clinical appeal or corrected claim.
• Assists with creating and reviewing department‑specific coding workflows and expectations.

• Matches charge documents to charge review & claim edit sessions, billing sheets, operative reports, and medical records to ensure correct codes are applied and billable services captured.
• Works charge review and claim edit sessions within two business days of posting to the assigned work queues.
• Investigates and appeals unpaid, denied, and partiallyктер搭…

• Pursues ongoing professional growth and development and participation in team meetings.
• Provides ongoing coding and documentation education to physicians and clinical staff.
• Attends, in person, quarterly coding and revenue integrity team meetings.

• Work Attire: Uniform – No;
  Scrubs – No;
  Business professional – Yes;
  Other – No
• On‑Call*: Employees may be required to be on‑call during emergencies (e.g., disaster, severe weather). On‑Call:
  No
• Travel**: Travel specifications may vary by department. Within Houston Metropolitan area – Yes;
  Outside Houston Metropolitan area – No

• Mid‑Senior level

• Full‑time

• Health Care Provider
• Hospital and Health Care (Industry)