Mid Coding Specialist II

UT Southwestern Medical Center • Dallas, TX

2d • Remote

About The Position

The successful candidate will work under general supervision to perform accurate and compliant coding of moderate-complexity medical and surgical specialties within a highly specialized academic medical center environment, with a primary focus on coding professional services for cardiology specialties. Exercises independent judgment in the review of encounters characterized by moderate to high documentation variability, NCCI bundling edits, payer-specific surgical policies, advanced modifier application, co-surgeon and trainee requirements, validation of incident-to/split-shared services and teaching physician documentation compliance. Evaluates and resolves AI-assisted coding exceptions to ensure coding accuracy, regulatory compliance, audit readiness, and appropriate reimbursement.

Requirements

• High School Diploma or GED Equivalent
• 2 years of coding and/or billing experience
• (CPC) CERT PROFESSIONAL CODER or
• (CCS-P) CERT CODING SPCLST PHY BA or
• (CMC) CERT MEDICAL CODER or
• (RHIA) REGD HEALTH INFO ADMINIST or
• (RHIT) REGD HEALTH INFO TECHNOLO or
• (CCS) CERT CODING SPECIALIST or
• (CPMA) Cert Prof Medical Auditor

Nice To Haves

• Experience coding moderate-complexity specialties and procedures requiring advanced bundling, modifier logic, and payer-specific rule application.
• Progressive professional billing and or coding responsibility and advanced technical proficiency.
• Experience in academic medical centers, multi-specialty physician groups, or complex ambulatory environments.
• Experience resolving charge review edits and back-end coding denials, including root-cause analysis and collaboration with providers and operational leaders.
• Experience supporting revenue integrity initiatives, compliance auditing, clinical documentation improvement (CDI), or operational performance improvement efforts.
• Experience working independently in a fast-paced, metric-driven, AI-enabled environment managing multiple work queues and shifting specialty assignments.

Responsibilities

• Meets productivity and quality standards set by coding leadership.
• Reviews and validate moderate-complex physician encounter documentation within Epic to ensure accurate and compliant documentation, ICD-10-CM, CPT, and HCPCS code assignment prior to claim submission.
• Identifies and mitigates compliance risks associated with moderate-complexity encounters, including multiple interdependent diagnoses, intermediate-risk procedures, split/shared and incident to services, and teaching physician documentation.
• May support multiple specialties in a hybrid role as needed.
• Reviews and resolves coding-related edits, including NCCI bundling conflicts, modifier application, MUE limits, payer-specific requirements, and global surgical package considerations.
• Evaluates, accepts, modifies, or overrides AI-generated coding outputs from Epic AI Code Assist/Complete, AI E&M LOS Assistant, and applicable third-party platforms using advanced clinical and regulatory judgment.
• Resolves AI exception flags, documentation discrepancies, and code conflicts to ensure audit readiness and clean claim release.
• Analyzes recurring coding edits, AI variances, and denial trends; performs root cause review and communicates findings to leadership when systemic issues are identified.
• Collaborates with providers to clarify documentation and ensure accurate code capture that supports medical necessity and reimbursement.
• Supports denial prevention efforts by partnering with billing and denial management teams to resolve coding-related rejections and underpayments.
• Maintains working knowledge of ICD-10-CM, CPT, HCPCS, payer policies, LCD/NCD guidelines, and regulatory updates.
• Participates in internal audits, quality assurance initiatives, Epic upgrades, and AI workflow optimization projects.
• May function in a float capacity, providing coding support to maintain operational coverage and productivity standards.
• Adheres to all organizational policies, compliance standards, data security requirements, and performance expectations.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED