Professional Coder II (Remote)

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.

Position 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 / Skills :

Minimum Education :

High School Diploma or equivalent required.

Minimum Experience :

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.