Coding Denial Specialist - Rev Cycle
🔍 Houston, Texas
- 💼
- McGovern Medical School at UTHealth Houston
- 📅
- 240003D7 Requisition #
What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.
Once you join us you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:
- 100% paid medical premiums for our full-time employees
- Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)
- The longer you stay, the more vacation you’ll accrue!
- Longevity Pay (Monthly payments after two years of service)
- Build your future with our awesome retirement/pension plan!
We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...
- Free financial and legal counseling
- Free mental health counseling services
- Gym membership discounts and access to wellness programs
- Other employee discounts including entertainment, car rentals, cell phones, etc.
- Resources for child and elder care
- Plus many more!
Position Summary:
RESTRICTED TO MMS/REVENUE CYCLE/CHARGE CAPTURE & CODING
The Coding Denial Specialist is responsible for resolving denied claims within the Charge Capture/Coding department under the direction of the Manager, Charge Capture & Coding and the Director, Charge Capture & Coding. The Denial Specialist collaborates with members of the Revenue Cycle Management (RCM) team including Clinical Documentation Improvement (CDI) to identify trends and develop rejection prevention strategies. This position is responsible for providing feedback using reports and data to coding managers. The Coding Denial Specialist applies official coding guidelines, payer policies and established departmental policies and procedures to resolve claim rejections ensuring that timely filing deadlines have not been exceeded.
UTHealth is looking for a detail-oriented and experienced Coding Denial Specialist to join our Revenue Cycle team. The ideal candidate will have a strong background in medical coding and billing, with a focus on identifying and resolving coding-related denials. This role involves analyzing denied claims, determining the root causes, and implementing corrective actions to ensure accurate and timely reimbursement. The specialist will work closely with healthcare providers and billing staff to educate them on coding guidelines and best practices. Excellent communication and problem-solving skills are essential, as the role requires effective collaboration to minimize future denials and optimize revenue cycle performance. If you are passionate about improving coding accuracy and have a keen eye for detail, we encourage you to apply and become a vital part of our team.
- Department: Revenue Cycle
- Status: Full-time
- Location: Remote (2 -4 weeks onsite for training @ 1851 Crosspoint Ave, 77054) meetings, additional training, etc.).
- Must live in Texas (TX)This is a Remote position, and you must reside in Texas
- Must be able to attend any required onsite meetings
**We DO NOT provide lodging or mileage reimbursement for training**
Position Key Accountabilities:
1. Performs timely and accurate review of coding related denials, appeal and submission, including tracking findings. Addresses denied claims and performs research to resolve coding related rejections. Reviews medical record and coded information to determine if coding needs to be changed or if an appeal is needed for resolution. Monitors and tracks denial trends to help identify education/feedback opportunities. Proactively monitors Revenue Cycle communications and payer websites for policy and guideline changes.
2. Responsible for reviewing underpayments in Rev Builder and resolving Claim Edits. Reviews charge sessions that require resolution via claim system edits in IDX and EPIC. Resolves edits per coding guidelines and department procedures. Performs reviews to validate missed coding opportunities and participates in meeting to review findings and provide feedback to coding leadership for coding education opportunities.
3. Performs other Coding functions as appropriate, including assisting with coding backlogs as necessary.
4. Adheres to established productivity standards and maintains tracking tools. Stays up-to-date with all federal, state and departmental coding guidelines and procedures. Attends department meetings to discuss denial trends and prevention opportunities.
5. Performs other duties as assigned.
Certification/Skills:
Must have one of the following certifications:
Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-based (CCS-P), or Certified Professional Coder (CPC). Knowledge of ICD-10 CM and CPT coding conventions. Proficiency in Microsoft Office suite, the ability to abstract data and maintain a database required
Effective verbal and written communication between internal and external customers
Excellent time management skills. Ability to work collaboratively in a remote environment.
Minimum Education:
High School Diploma or equivalent. Associates degree in Health Information Management or related healthcare field is preferred.
Minimum Experience:
3 years of experience in a Health Information Management (HIM) multi-specialty coding. Strong professional (pro-fee) coding experience in multi-specialty clinic, EPIC/IDX and Cerner EMR experience is preferred.
May substitute required experience with equivalent years of education beyond the minimum education requirement.
Physical Requirements:
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
Security Sensitive:
This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215
Residency Requirement:
Employees must permanently reside and work in the State of Texas.
If you are looking for a great healthcare career in Houston, visit http://go.uth.edu/careers!
University of Texas Health Science Center at Houston (UTHealth)
Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth Houston is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing and public health and the John P. and Kathrine G. McGovern Medical School. UTHealth Houston includes The University of Texas Harris County Psychiatric Center, as well as the growing clinical practices UT Physicians, UT Dentists and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital.
UTHealth Benefits
UTHealth Houston offers a comprehensive and competitive benefits package. For more information on our benefits programs please refer to the UTHealth Houston Office of Benefits Website.
Equal Employment Opportunity Statement
UTHealth Houston is committed to providing equal opportunity in all employment-related activities without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, genetic information, gender identity or expression, veteran status or any other basis prohibited by law or university policy. Reasonable accommodation, based on disability or religious observances, will be considered in accordance with applicable law and UTHealth Houston policy. The University maintains affirmative action programs with respect to women, minorities, individuals with disabilities, and eligible veterans in accordance with applicable law.
UTHealth Houston has adopted a policy consistent with CMS regulations to protect our patients and university community from exposure to COVID-19. This policy affects all employees, residents, fellows, students, contractors, new hires, visiting scholars program participants, adjunct faculty, and volunteers who work, train, or collaborate at the John S. Dunn Behavioral Science Center.
In addition, all UTHealth Houston employees who are assigned to work at a location that is subject to the affiliated partner’s hospital, clinical offices, or agency are required to abide by UTHealth’s Houston rules and regulations, as well as the affiliate’s rules and regulations, including COVID-19 vaccination and safety requirements.
Work location is based on the needs of the department and may be adjusted.
