Pediatric Professional Coding Specialist III

OU Health•Tulsa, MO

9d•Remote

About The Position

This position will be responsible for overseeing pediatric areas for coding assistance, including follow-up, as well as fielding staff questions around pediatric billing in general. Senior subject matter expert responsible for the most complex pro fee coding portfolios and serving as a functional team lead through mentoring, training, and escalation support. Ensures compliant coding, high audit defensibility, and stable production across multi‑setting pro fee services in an academic, multi‑specialty and research enterprise.

Requirements

High School diploma or GED required.
At least 5 years of experience of physician/provider coding required.
CPC or CCS-P required
Additional specialty credential required such as CPMA, CEMC, CRC or other specialty credentials (e.g. COPC, CEDC, CGIC, CIRCC or other)

Responsibilities

Code and resolve the most complex, high‑risk professional encounters including specialty‑specific procedures, high‑dollar services, complex modifier scenarios, and telehealth exceptions.
Serve as an escalation resource for coding disputes, payer policy conflicts, and documentation challenges; provide definitive guidance consistent with coding standards.
Support training and mentoring of Coding Specialists I–II; assist with onboarding, competency development, job aid creation, and informal in‑service education.
Ability to teach and coach peers; translate guidelines into practical, consistent coding decisions and training artifacts.
Contribute to coding quality management through audits and trend analysis; recommend process improvements and targeted education based on findings.
High autonomy, prioritization skills, and risk ownership for audit‑sensitive services and complex claims.
Partner with clinical leadership and compliance to support documentation improvement and mitigate coding/audit risk; support consistent query practices.
Expert coding knowledge across assigned specialties and settings; advanced modifier and payer policy interpretation; strong documentation standard expertise.
Strong analytical and communication skills to influence documentation improvement and reduce downstream denials.
Performs other duties as assigned