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UT Southwestern Medical Center

Academic medical center and health system

Coding Specialist III

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeTexas, USANo salary listed

About the Job

Requirements

  • High school diploma or GED equivalent.
  • Four years of coding and/or billing experience.
  • Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding systems, including global surgical package rules, complex modifier application and sequencing, and advanced procedure coding guidelines, depending on specialty assignment.
  • Ability to interpret complex clinical documentation and apply accurate coding in accordance with coding guidelines and payer requirements.
  • Comprehensive understanding of medical terminology, anatomy, physiology, and specialty-specific documentation requirements.
  • Comprehensive understanding of federal and state regulations, payer policies, compliance standards, and reimbursement methodologies, including NCCI edits and modifier application, teaching physician documentation guidelines, and academic billing requirements.
  • Advanced knowledge of AI-assisted coding technologies and their application in coding workflows may be required.
  • Advanced proficiency in Epic Professional Billing or other electronic health record and billing systems.
  • Advanced analytical, critical-thinking, and problem-solving skills, along with 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, with organizational skills to meet productivity, quality, and performance metrics while maintaining accuracy, compliance, customer service, and continuous improvement.
  • Must live within the State of Texas.
  • Preferred experience coding high-complexity specialties and procedures requiring advanced bundling, modifier logic, and payer-specific rule application.
  • Preferred progressive professional billing and coding experience and advanced technical proficiency.
  • Preferred experience in academic medical centers, multi-specialty physician groups, or complex ambulatory environments.
  • Preferred experience resolving charge review edits and back-end coding denials, including root-cause analysis and collaboration with providers and operational leaders.
  • Preferred experience supporting revenue integrity initiatives, compliance auditing, clinical documentation improvement, or operational performance improvement efforts.
  • Preferred experience working independently in a fast-paced, metric-driven, AI-enabled environment managing multiple work queues and shifting specialty assignments.
  • Preferred certification: Certified Professional Coder (CPC), Certified Coding Specialist–Physician-based (CCS-P), Certified Medical Coder (CMC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA).

Responsibilities

  • Meet productivity and quality standards set by coding leadership.
  • Review and validate high-complexity physician encounter documentation within Epic to ensure accurate and compliant documentation and ICD-10-CM, CPT, and HCPCS code assignment before claim submission.
  • Identify and mitigate compliance risks associated with high-complexity encounters, including multiple interdependent diagnoses, high-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 from Epic AI Code Assist/Complete, AI E&M LOS Assistant, and applicable third-party platforms using advanced clinical and regulatory judgment, as needed.
  • Resolve AI exception flags, documentation discrepancies, and code conflicts to ensure audit readiness and clean claim release, as needed.
  • Analyze recurring coding edits, AI variances, and denial trends; perform root-cause review and communicate findings to leadership when systemic issues are identified.
  • Collaborate with providers to clarify documentation and ensure accurate code capture that supports medical necessity and reimbursement.
  • Support denial prevention efforts by partnering with billing and denial management teams to resolve coding-related rejections and underpayments.
  • Maintain advanced knowledge of ICD-10-CM, CPT, HCPCS, payer policies, LCD/NCD guidelines, and regulatory updates.
  • Participate in internal audits, quality assurance initiatives, Epic upgrades, and AI workflow optimization projects as needed.
  • Provide coding support in a float capacity to maintain operational coverage and productivity standards, as needed.
  • Adhere to organizational policies, compliance standards, data security requirements, and performance expectations; perform additional assigned duties.
  • Code and audit patient encounters to ensure accurate documentation.
  • Code for the OBGYN department.
  • Apply governmental and payer policies to coding guidelines.

About the Company

UT Southwestern Medical Center

Academic medical center and health system

UT Southwestern Medical Center is an academic medical center in Dallas, Texas, integrating patient care, biomedical research, and medical education. It operates a main campus and regional medical centers alongside four schools, including a medical school and graduate programs in health professions and public health. What sets UT Southwestern apart is research output ranked No. 1 worldwide by the Nature Index, backed by Nobel laureates on faculty. The goal is to advance medical discovery into better treatments and compassionate patient care.

Company size
Not listed
Company stage
Grant
Total funding
$18M
Headquarters
Dallas, TX
Founded
Not listed

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