Pediatric Professional Coding Specialist III

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Job Description:

Ask your recruiter about our competitive wages and total rewards package!

Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.

This position will be responsible for overseeing pediatric areas for coding assistance, including follow-up, as well as fielding staff questions around pediatric billing in general.

General Description

Senior subject matter expert responsible for the most complex pro fee coding portfolios and serving as a functional team lead through mentoring, training, and escalation support. Ensures compliant coding, high audit defensibility, and stable production across multi‑setting pro fee services in an academic, multi‑specialty and research enterprise. 

Essential Job Duties

Responsibilities listed in this section are core to the position.  Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. 

• Code and resolve the most complex, high‑risk professional encounters including specialty‑specific procedures, high‑dollar services, complex modifier scenarios, and telehealth exceptions. 

• Serve as an escalation resource for coding disputes, payer policy conflicts, and documentation challenges; provide definitive guidance consistent with coding standards. 

• Support training and mentoring of Coding Specialists I–II; assist with onboarding, competency development, job aid creation, and informal in‑service education. Ability to teach and coach peers; translate guidelines into practical, consistent coding decisions and training artifacts. 

• Contribute to coding quality management through audits and trend analysis; recommend process improvements and targeted education based on findings. High autonomy, prioritization skills, and risk ownership for audit‑sensitive services and complex claims. 

• Partner with clinical leadership and compliance to support documentation improvement and mitigate coding/audit risk; support consistent query practices. 

• Expert coding knowledge across assigned specialties and settings; advanced modifier and payer policy interpretation; strong documentation standard expertise. 

• Strong analytical and communication skills to influence documentation improvement and reduce downstream denials. 

General Job Duties

• Performs other duties as assigned

Minimum Requirements

Education: High School diploma or GED required.

Experience: At least 5 years of experience of physician/provider coding required.

Certification/License/Registration: CPC or CCS-P required - Additional specialty credential required such as  CPMA, CEMC, CRC or other specialty credentials (e.g. COPC, CEDC, CGIC, CIRCC or other)

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.