Professional Coding Specialist II

 Posted 4 hours ago
     
2-5 years experience
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AI Summary

Independently perform complex professional coding across multiple specialties and settings to ensure compliant reimbursement and audit defensibility. Resolve coding edits and denials while providing guidance to peers and supporting documentation improvement workflows.

Position Title:

Professional Coding Specialist II

Department:

Revenue Integrity

Job Description:

New to OU Health?  Ask your recruiter about our competitive wages and total rewards package.

Looking for a coding team to love at OU Health? This is it! While this role is specifically searching for an experienced coder. 100% remote. Flexible shifts once training is complete. Opportunity to work four 9 hour days, and one 4 hour day. So if you're work-from-home ready, work well independently, and have strong coding skills we just may be the right fit for you!

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

***The ideal candidate would have teaching hospital or trauma center coding experience (coding knowledge in multiple specialties is a big plus). Epic and Encoder Pro experience preferred.***

General Description

Independently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic 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 complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD‑10‑CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation. 

  • Resolve coding-related edits and denials by identifying root cause, coordinating documentation clarification, and supporting rebilling actions as applicable. 

  • Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules as relevant to pro fee claims. 

  • Provide real‑time guidance to peers on standard coding scenarios; promote consistency through best‑practice sharing. 

  • Participate in internal quality review programs and implement education/corrective actions based on findings. 

  • Proficiency in Epic professional coding work queues and encoder tools; ability to efficiently review documentation in the EHR across settings. 

  • Analytical problem solving for denial/edits prevention; ability to identify documentation improvement opportunities and support compliant query workflows

  • Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations. 

General Job Duties

  • Performs other duties as assigned

Education:  High School diploma or GED required.

Experience: At least 3 years of experience physician/provider coding required.

Certification/License/Registration: CPC or CCS-P required

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Current OU Health Employees - Please click HERE to login.

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.

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