Mid Coding Specialist II, Revenue Cycle

UT Southwestern Medical Center•Dallas, TX

10h•Remote

About The Position

The Mid Coding Specialist II works under general supervision to perform accurate and compliant coding of moderate-complexity medical and surgical specialties in a highly specialized academic medical center, with a primary focus on cardiology professional services. The role uses independent judgment to review encounters involving documentation variability, NCCI bundling edits, payer-specific surgical policies, advanced modifier application, co-surgeon and trainee requirements, incident-to and split/shared services, and teaching physician documentation. The specialist evaluates and resolves AI-assisted coding exceptions to support coding accuracy, regulatory compliance, audit readiness, and appropriate reimbursement. This is a work-from-home opportunity for candidates who live in Texas, with an eight-hour weekday schedule, Monday through Friday. The position works in Epic and other AI-enabled coding workflows and may support multiple specialties or provide float coverage as needed.

Requirements

High school diploma or GED equivalent.
Two years of coding and/or billing experience.
Working knowledge of ICD-10-CM, CPT, and HCPCS coding, including modifier sequencing, multiple procedure guidelines, and bilateral surgical rules.
Ability to interpret moderate-complexity clinical documentation and apply coding guidelines and payer requirements accurately.
Thorough understanding of medical terminology, anatomy, physiology, and specialty-specific documentation requirements.
Thorough understanding of federal and state regulations, payer policies, compliance standards, and reimbursement methodologies, including NCCI edits and modifier application; working knowledge of teaching physician documentation guidelines and academic billing requirements.
Working knowledge of AI-assisted coding technologies and their use in coding workflows, including Epic AI tools and third-party platforms.
Advanced proficiency in Epic Professional Billing or another electronic health record and billing system.
Advanced analytical, critical-thinking, and problem-solving skills, and effective communication skills.
Ability to work independently, manage multiple priorities in a fast-paced technology-enabled environment, and meet productivity, quality, and performance metrics.
Ability to maintain accuracy, compliance, customer service, and a commitment to continuous improvement.
One of the following certifications: CPC, CCS-P, CMC, RHIA, RHIT, CCS, or CPMA.

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, or operational performance improvement.
Experience working independently in a fast-paced, metric-driven, AI-enabled environment while managing multiple work queues and shifting specialty assignments.

Responsibilities

Meet productivity and quality standards set by coding leadership.
Review and validate moderate-complexity physician encounter documentation in Epic and assign accurate, compliant ICD-10-CM, CPT, and HCPCS codes before claim submission.
Identify and mitigate compliance risks involving multiple interdependent diagnoses, intermediate-risk procedures, split/shared and incident-to services, and teaching physician documentation.
Support multiple specialties in a hybrid role as needed.
Review and resolve coding-related edits, including NCCI bundling conflicts, modifier application, MUE limits, payer-specific requirements, and global surgical package considerations.
Evaluate, accept, modify, or override AI-generated coding outputs using clinical and regulatory judgment.
Resolve AI exception flags, documentation discrepancies, and code conflicts to support audit readiness and clean claim release.
Analyze recurring coding edits, AI variances, and denial trends; perform root-cause reviews and communicate systemic issues to leadership.
Collaborate with providers to clarify documentation and ensure accurate code capture supporting medical necessity and reimbursement.
Partner with billing and denial management teams to prevent denials and resolve coding-related rejections and underpayments.
Maintain working knowledge of coding systems, payer policies, LCD/NCD guidelines, and regulatory updates.
Participate in internal audits, quality assurance initiatives, Epic upgrades, and AI workflow optimization projects.
Provide float coding support as needed to maintain operational coverage and productivity standards.
Follow organizational policies, compliance standards, data security requirements, and performance expectations.
Perform other duties as assigned.

Benefits

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