Professional Coder III - Rev Cycle (Finance)

What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in.

Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus:

• 100% paid medical premiums for our full-time employees
• Generous time off (holidays, preventative leave day, both vacation and sick time - all of which equates to around 37-38 days per year)
• The longer you stay, the more vacation you'll accrue!
• Longevity Pay (Monthly payments after two years of service)
• Build your future with our awesome retirement/pension plan!

We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as...

• Free financial and legal counseling
• Free mental health counseling services
• Gym membership discounts and access to wellness programs
• Other employee discounts including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care
• Plus many more!

Position Summary:

The Professional Coder III 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 mainly responsible for inpatient/outpatient complex procedural coding including anesthesia. May also be responsible for coding E/M encounters, ancillary diagnostic procedures and other outpatient visits.

UTHealth is hiring for a Professional Coder III to join their team of professionals in Revenue Cycle - Charging Code and Capture. The Certified Coder will be responsible for coding ACTAT and resolving edits. Cardiology coding experience and familiarity with Epic are a plus!

• Department: Revenue Cycle
• Status: Full-time
• Location: Remote (2 -4 weeks onsite for training @ 1851 Crosspoint Ave, 77054) meetings, additional training, etc.).
• Must live in Texas (TX) This is a Remote position, and you must reside in Texas
• Must also be able to attend any required onsite meetings

We DO NOT provide lodging or mileage reimbursement for training

Position Key Accountabilities:

• Reviews medical record and accurately assigns and sequences CPT, ICD-10CM, and HCPCS codes/modifiers for complex surgical procedures including anesthesia, ensuring compliance with all applicable guidelines.
• May also be responsible for reviewing E/M encounters or diagnostic tests.
• Generates physician queries in accordance to established procedures and monitors resolution.
• Responsible for resolving all coding related edits in a timely manner.
• May be required to provide physician education or feedback.
• Confirms that all applicable UTHealth and Coding Guidelines are being followed.
• Responsible for provider feedback/education, manual charge entry and charge reconciliation.
• 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.
• 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.
• Stays up-to-date with all federal, state, coding & departmental guidelines and procedures.
• Performs other duties as assigned.

Certification/Skills:

• RHIA - Registered Health Information Administrator required or
• RHIT - Registered Health Information Technician required or
• CCS-Certified Coding Specialist required or
• Certified Coding Specialist Physician-based (CCS-P) required or
• Certified Professional Coder (CPC) required or
• Radiology Coding Certification (RCC) required

• 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:

• 5 years experience in Health Information Management (HIM) coding. required
• 2 years experience of complex coding experience including surgical or anesthesia pro-fee preferred
• Clinic and 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.

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.

Security Sensitive:

This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

Residency Requirement:

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