CODING SPEC III - OUTPATIENT

UT Southwestern Medical Center•Dallas, TX

About The Position

The Coding Spec III - Outpatient is responsible for retrospective outpatient account coding using ICD-10-CM and CPT in compliance with Official Coding Guidelines and conventions. The role accurately identifies the reason for visit, first-listed (primary) diagnosis, procedures, modifiers, and secondary diagnoses to support medical necessity and applicable LCD/NCD and CCI edits. It also abstracts required data elements, including discharge disposition and destination, procedure dates and physicians, occurrence codes, and other designated data. The coder may review accounts in denials work queues and make recommendations to the Coding Manager. Responsibilities include identifying when physician queries are appropriate, recognizing and appropriately routing missing or incomplete documentation, validating chargemaster-driven CPT code assignments and routing them as appropriate, and completing review and final coding when query responses or documentation become available. The position maintains UTSW/HIM Coding quality and productivity standards, maintains expert knowledge of coding guidelines and practices, and may mentor or train on designated coding service lines. Other duties may be assigned.

Requirements

High school diploma or equivalent.
Three years of acute hospital-based coding experience, or an equivalent combination of education and experience.
One of the following credentials: RHIA, RHIT, CCS, COC, CPC, AAPC Certified Professional Coder-Hospital (CPC-H), or CIRCC.

Nice To Haves

Associate's or bachelor's degree in Health Information Management or a closely related field.
Experience working in a remote environment; required for PRN coders.

Responsibilities

Code retrospective outpatient accounts using ICD-10-CM and CPT in compliance with Official Coding Guidelines and conventions.
Identify the appropriate reason for visit, first-listed (primary) diagnosis, procedures, modifiers, and secondary diagnoses to support medical necessity and LCD/NCD and CCI edits.
Abstract required data elements, including discharge disposition and destination, procedure dates and physicians, occurrence codes, and other designated data.
Review accounts in denials work queues when assigned and make recommendations to the Coding Manager.
Identify when a physician query is appropriate for clarification.
Recognize missing or incomplete documentation and route it appropriately.
Validate chargemaster-driven CPT code assignments and route them appropriately.
Complete review and final coding when queries or documentation are available.
Maintain UTSW/HIM Coding quality and productivity standards.
Maintain expert knowledge of coding-related guidelines and practices.
Mentor or train on designated coding service lines as requested.
Perform other duties as assigned.

Benefits

PPO medical plan available on day one at no cost for full-time employee-only coverage.
100% coverage for preventive healthcare with no copay.
Paid time off available on day one.
Retirement programs through the Teacher Retirement System of Texas (TRS).
Paid parental leave benefit.
Wellness programs.
Tuition reimbursement.
Public Service Loan Forgiveness (PSLF) qualified employer.
On-site childcare.
Paid holidays.