What are the responsibilities and job description for the Lead Coding Specialist position at UT Southwestern?
WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report , we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!
JOB SUMMARY
The Lead Coder is responsible to review inpatient and/or outpatient University of Texas Southwestern Medical Center (UTSW) hospital medical records, for coding accuracy, claim edits, denials, DNB and Stop Bill reviews, combined accounts, DRG Validation & Mismatch reviews, and Coder questions. The UTSW medical records are maintained in electronic format and reviews will be in accordance with current coding guidelines, and in compliance with organizational, departmental, and regulatory requirements. The Lead Coder is identified as the highest level coding subject matter expert due to education, training, and experience and as such will receive assignments in accordance with that level of expertise. Additionally, the Lead Coder may be asked to mentor and proctor employees at the Coding Specialist I, II, and III levels.
BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
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
Learn more about these and other UTSW employee benefits!
EXPERIENCE AND EDUCATION
Required
Experience
3 years to five (3-5) years acute hospital-based coding experience
An equivalent combination of education and experience may be considered.
Licenses and Certifications
(RHIA) REGD HEALTH INFO ADMINIST Upon Hire or
(RHIT) REGD HEALTH INFO TECHNOLO Upon Hire or
(CCS) CERT CODING SPECIALIST AHIMA Certified Coding Specialist (CCS) Upon Hire or
(CPC) CERT PROFESSIONAL CODER AAPC credential - Certified Professional Coder (CPC) (Prior to 2014) Upon Hire or
(COC) Certified Outpatient Coding (excludes AAPC Apprentice) Upon Hire
Preferred
Education
Bachelor's Degree in Health Information Management and/or closely related field or
Associate's Degree in Health Information Management and/or closely related field
Experience
Experience working in a remote environment preferred.
JOB DUTIES
Responsible for reviewing inpatient and/or outpatient accounts using ICD-10 CM and/or I10-PCS or CPT, in compliance with the Official Coding Guidelines and conventions.
Accurately identifies most appropriate Principal Diagnosis, Reason for Visit, and Procedures, for the DRG or APC, and all secondary diagnoses to accurately reflect all CC/MCC's, POA status, Severity of Illness & Risk of Mortality, SDOH, and HCC's.
Accurately reviews abstracting for required data elements including, discharge disposition, discharge destination, procedure dates and physician(s), and other designated data.
Identifies when a physician query is appropriate for further clarification.
Recognizes when the documentation is missing or incomplete and routes appropriately.
Support the Quality Standards set by UTSW/HIM Coding.
Mentor/train on designated coding service lines as requested to ensure quality.
Maintains an expert level of knowledge of coding related guidelines and practices.
Other duties as assigned
SECURITY AND EEO STATEMENT
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. To the extent this position requires the holder to research, work on, or have access to critical infrastructure as defined in Section 113.001(2) of the Texas Business and Commerce Code, the ability to maintain the security or integrity of the critical infrastructure is a minimum qualification to be hired and to continue to be employed in the position.
EEO Statement
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Benefits UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
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
Learn more about these and other UTSW employee benefits!
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report , we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!
JOB SUMMARY
The Lead Coder is responsible to review inpatient and/or outpatient University of Texas Southwestern Medical Center (UTSW) hospital medical records, for coding accuracy, claim edits, denials, DNB and Stop Bill reviews, combined accounts, DRG Validation & Mismatch reviews, and Coder questions. The UTSW medical records are maintained in electronic format and reviews will be in accordance with current coding guidelines, and in compliance with organizational, departmental, and regulatory requirements. The Lead Coder is identified as the highest level coding subject matter expert due to education, training, and experience and as such will receive assignments in accordance with that level of expertise. Additionally, the Lead Coder may be asked to mentor and proctor employees at the Coding Specialist I, II, and III levels.
BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
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
Learn more about these and other UTSW employee benefits!
EXPERIENCE AND EDUCATION
Required
Experience
3 years to five (3-5) years acute hospital-based coding experience
An equivalent combination of education and experience may be considered.
Licenses and Certifications
(RHIA) REGD HEALTH INFO ADMINIST Upon Hire or
(RHIT) REGD HEALTH INFO TECHNOLO Upon Hire or
(CCS) CERT CODING SPECIALIST AHIMA Certified Coding Specialist (CCS) Upon Hire or
(CPC) CERT PROFESSIONAL CODER AAPC credential - Certified Professional Coder (CPC) (Prior to 2014) Upon Hire or
(COC) Certified Outpatient Coding (excludes AAPC Apprentice) Upon Hire
Preferred
Education
Bachelor's Degree in Health Information Management and/or closely related field or
Associate's Degree in Health Information Management and/or closely related field
Experience
Experience working in a remote environment preferred.
JOB DUTIES
Responsible for reviewing inpatient and/or outpatient accounts using ICD-10 CM and/or I10-PCS or CPT, in compliance with the Official Coding Guidelines and conventions.
Accurately identifies most appropriate Principal Diagnosis, Reason for Visit, and Procedures, for the DRG or APC, and all secondary diagnoses to accurately reflect all CC/MCC's, POA status, Severity of Illness & Risk of Mortality, SDOH, and HCC's.
Accurately reviews abstracting for required data elements including, discharge disposition, discharge destination, procedure dates and physician(s), and other designated data.
Identifies when a physician query is appropriate for further clarification.
Recognizes when the documentation is missing or incomplete and routes appropriately.
Support the Quality Standards set by UTSW/HIM Coding.
Mentor/train on designated coding service lines as requested to ensure quality.
Maintains an expert level of knowledge of coding related guidelines and practices.
Other duties as assigned
SECURITY AND EEO STATEMENT
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. To the extent this position requires the holder to research, work on, or have access to critical infrastructure as defined in Section 113.001(2) of the Texas Business and Commerce Code, the ability to maintain the security or integrity of the critical infrastructure is a minimum qualification to be hired and to continue to be employed in the position.
EEO Statement
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Benefits UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
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
Learn more about these and other UTSW employee benefits!
