Coding & Reimburs Spec

Texas Tech University•Odessa, TX

About The Position

This role involves adhering to the Standards of Ethical Coding as set forth by the American Association of Professional Coders (AAPC) and following official coding guidelines and the Values Based Culture of Texas Tech University Health Sciences Center. The primary responsibility is to review official medical records with physician/healthcare provider documentation and assign appropriate codes for all services. This includes procedural, diagnosis, and supply codes across all places of service, ensuring accuracy, completeness, and timeliness. The position requires maintaining compliance with federal regulations, HIPAA, payer policies, and organizational coding standards. Collaboration with providers to resolve documentation deficiencies and coding issues is essential, as is participation in audits, quality improvement, and continuing education to stay current with coding practices and regulations. Adaptability to changes in coding guidelines, payer regulations, and EHR workflows is also a key aspect of the role.

Requirements

High school diploma or equivalent required.
Two (2) years of medical coding, reimbursement, or medical billing experience, including procedural and diagnosis coding, preferably in a physician group, healthcare organization, or academic healthcare setting; OR Current coding certification from the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).
Certification must be maintained throughout employment.

Responsibilities

Reviews official medical records with physician/healthcare provider documentation and assigns appropriate codes for all physician/healthcare provider services from current editions of official coding sources.
Ensures accurate, complete, and timely code assignments for all physician/healthcare provider services to include procedural, diagnosis, and supplies in all places of service.
Reviews physician documentation and accurately assigns ICD-10-CM, CPT, and HCPCS codes in accordance with official coding guidelines, payer requirements, and organizational policies.
Ensures coding accuracy, completeness, and timely submission while meeting established productivity and quality standards.
Maintains compliance with federal regulations, HIPAA requirements, payer policies, and organizational coding standards.
Identifies documentation deficiencies and collaborates with providers to obtain clarification and support accurate code assignment.
Partners with providers, billing staff, and other departments to resolve coding issues and facilitate timely claims processing.
Participates in coding audits, quality improvement initiatives, continuing education, and process improvement efforts to maintain coding proficiency and regulatory compliance.
Adapts to changes in coding guidelines, payer regulations, and electronic health record (EHR) workflows while supporting departmental and organizational initiatives.
Performs other duties as assigned.