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Reviews and interprets patient medical records documentation to identify pertinent diagnoses and procedures and assigns ICD-10-CM, ICD-10-CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for ambulatory surgery, special procedure, observation, emergency department, outpatient ancillary and clinic visit records. The Certified Coding Specialist II requires advanced knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines.

Cook Children's Health Care System

Certified Coding Specialist II

We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. To thrive in this role, you must have experience identifying different types of hospital documentation including, but not limited to, medical records, UB-04s, EOBs, itemized bills, hospital account notes, appeal letters, and denial/approval letters.

YEAR

R1 RCM Inc

Clinical Coding Appeals Nurse

Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.

Astrana Health, Inc.

Risk Adjustment Coding Specialist II - Houston

PinpointHQ

The estimated base pay range per hour for this role is: $20—$35 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.

HOUR

Datavant

Coding Consultant Outpatient - PRN - Billing/Edits/Denials

GreenHouseAPI

In this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Clinical Coding Analyst RN, Consultant

License/Certification: One or more of the following certifications may be required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC). Validates accuracy of diagnostic and procedural coding, payment methodology, and reimbursement amount; develops written rationale of findings; responds to providers for resolution of appeals.

Centene Management Company

Coding Quality Specialist

Minimum Requirements: Requires a BA/BS degree and a minimum of 5 years of related medical policy experience including prior experience leading large, multi-stakeholder regional or enterprise projects; or any combination of education and experience which would provide an equivalent background. Primary duties may include, but are not limited to: Conceptualizes implementation approaches that consider both broad business issues/objectives across regions and detailed considerations of adjudication systems, benefit design, and regulatory environments that vary by region.

Elevance Health

Implement & Coding Consultant

ea_via_bold

Elevance Health Inc

FULL_TIME

This individual will analyze itemized hospital bills and claims data to identify billing errors, coding discrepancies, DRG misassignments, and other overpayment opportunities, then work directly with claims administrators on behalf of our ASO clients to secure claim adjustments, recoveries, and repricing. We are seeking an experienced Senior Claims Analyst with deep expertise in hospital claims adjudication, stop loss reporting, high-cost/catastrophic claims, and DRG (Diagnosis-Related Group) reimbursement methodology.

SmartLight Analytics

Payment Integrity Nurse Reviewer- Hospital Claims

partner JazzHR

In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. Ascertains the accuracy of the physicians'' E/M and procedure coding to their documentation, completes the auditing reporting tool, and provides feedback to the education team and/or provider.

Texas Children's Hospital

Coding Quality Assurance Specialist II

OTHER

Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Strong knowledge of CPT, HCPCS, ICD-10-CM, Evaluation and Management services, modifiers, medical necessity, provider documentation requirements, payer billing requirements, CMS guidance, NCCI edits, LCDs, NCDs, and professional fee reimbursement required.

Texas Oncology

Sr. Coding Quality Analyst

[AW]-iCims

As a key member of the Coding and Documentation leadership team, this position will report to the CFAO, and assume a strategic role in the oversight of the company's coding, documentation and audit/education departments to support both the owned clinic and affiliate business. The Senior Director provides leadership and direction to the team, as well as collaborates with senior leadership to ensure that all coding and documentation functions are aligned with compliance and clinical requirements and are in accordance with the mission, vision, values and policies of Cano Health.

Cano Health Inc

Sr. Director Coding and Documentation

Registered Health Information Technician (RHIT) by American Health Information Management Association (AHIMA) within 6 months of hire required or Certified Coding Specialist (CCS) by American Health Information Management Association (AHIMA) within 6 months of hire required or Certified Coding Specialist - Physician-based (CCS-P) by American Health Information Management Association (AHIMA) within 6 months of hire required or Certified Professional Coder (CPC) by American Academy of Professional Coders (AAPC) within 6 months of hire required or Radiology Coding Certification (RCC) by Radiology Coding Certification Board (RCCB) within 6 months of hire requiredMinimum Education:High School Diploma or equivalent required Minimum Experience:2 years Related coding experience requiredPhysical 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. 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!

University of Texas Health Science Center at Houston

Certified Coding Specialist I/II/III- Ob/Gyn

Texas Children's comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children's Hospital West Campus, a community hospital in suburban West Houston; Texas Children's Hospital The Woodlands, the first hospital devoted to children's care for communities north of Houston; and Texas Children's Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children's Health Plan, the nation's first HMO focused on children; Texas Children's Pediatrics, the largest pediatric primary care network in the country; Texas Children's Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world.

Manager Coding Quality/Education

This role functions as the primary liaison between Revenue Cycle, clinical providers, and coding teams, supporting documentation and coding improvement through education and collaboration This role leads initiatives to improve documentation integrity, coding accuracy, compliant charge capture, and revenue performance through targeted provider education, coding audits, workflow evaluation, and continuous improvement strategies. Through prospective and retrospective audits, the role identifies documentation gaps, coding inaccuracies, denial drivers, and compliance risks, and partners with clinical, operational, coding, and compliance leadership to drive measurable improvement in provider documentation quality and reimbursement outcomes.

TRAVIS COUNTY HEALTHCARE DISTRICT

Supervisor, Revenue Cycle and Coding Specialist

Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts. Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG), All Patient Refined Diagnosis Related Groups (APDRG), and Ambulatory Payment Classification (APC).

Texas Scottish Rite for Children

Coding Manager

Central Health

Provides status, leads discussion of change requests, and organizes routine and ad-hoc meetings with Suspecting Governance, Working Group Committee and Clinical Actions leaders. Primary Responsibilities: Evaluates clinical and medical coding appropriateness of the suspecting engines with the goal of defining improvement needs and escalation to leadership.

divvyDOSE

Lead Clinical Nurse Analyst - San Antonio, | Antonio, |

IRecruitee

Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. Maintains master online reference list of organizational stakeholders involved in charge entry to view internal controls on charge reconciliation, document any significant revenue impact issues and to assist in the efficient resolution of those issues.

Houston Methodist Hospital

Charge Description Master Coordinator

The Coding Specialist is responsible for accurately assigning and sequencing ICD diagnostic and procedural codes and/or CPT procedural codes to inpatient and outpatient records. Abstract medical data from the record to complete a discharge abstract on each inpatient, ambulatory surgery, emergency room, outpatient, and ancillary visit, completing and verifying diagnostic and demographic information.

Medical Coder Jobs in Texas

Certified Coding Specialist II Cook Children's Health Care System

Clinical Coding Appeals Nurse R1 RCM Inc

Risk Adjustment Coding Specialist II - Houston Astrana Health, Inc.

Coding Consultant Outpatient - PRN - Billing/Edits/Denials Datavant

Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield Association

Coding Quality Specialist Centene Management Company

Implement & Coding Consultant Elevance Health

Implement & Coding Consultant Elevance Health Inc

Payment Integrity Nurse Reviewer- Hospital Claims SmartLight Analytics

Coding Quality Assurance Specialist II Texas Children's Hospital

Sr. Coding Quality Analyst Texas Oncology

Sr. Director Coding and Documentation Cano Health Inc

Certified Coding Specialist I/II/III- Ob/Gyn University of Texas Health Science Center at Houston

Manager Coding Quality/Education Texas Children's Hospital

Supervisor, Revenue Cycle and Coding Specialist TRAVIS COUNTY HEALTHCARE DISTRICT

Coding Manager Texas Scottish Rite for Children

Supervisor, Revenue Cycle and Coding Specialist Central Health

Lead Clinical Nurse Analyst - San Antonio, | Antonio, | divvyDOSE

Charge Description Master Coordinator Houston Methodist Hospital

Coding Specialist Chesapeake Regional Healthcare

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