[Hiring] Mid Coding Specialist II @UT Southwestern Medical Center

Role Description

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. Responsibilities include:

• Exercising independent judgment in the review of encounters characterized by moderate to high documentation variability.
• Evaluating and resolving AI-assisted coding exceptions to ensure coding accuracy, regulatory compliance, audit readiness, and appropriate reimbursement.

Shift: 8-hour days, Monday through Friday

Work From Home (WFH): This is a WFH opportunity. Candidates must live in TX.

Qualifications

• High School Diploma or GED Equivalent.
• 2 years of coding and/or billing experience.

Requirements

• 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.
• Licenses and Certifications: (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.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage.
• 100% 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.

Job Duties

• Meets productivity and quality standards set by coding leadership.
• Reviews and validates 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.
• 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.
• 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.
• 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.
• 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.

Knowledge, Skills and Abilities

• Working knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
• Ability to interpret moderate-complexity clinical documentation and accurately apply coding guidelines and payer requirements.
• 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.
• Working knowledge of AI-assisted coding technologies and their application in coding workflows.
• Advanced proficiency in Epic Professional Billing or other electronic health record (EHR) and billing systems.
• Advanced analytical, critical-thinking, and problem-solving skills.
• Effective communication skills to support coding accuracy, resolve issues, educate providers, and collaborate with cross-functional teams.
• Ability to work independently and manage multiple priorities in a fast-paced, technology-enabled environment.

Physical Requirements/Working Conditions

• Repetitive Motions.
• Sitting.
• Indoors.
• Office Setting.

Salary Information

Salary is commensurate with education, skills, and relevant experience.

Security and EEO Statement

This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.

UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community.