Lead Coding Specialist, InPatient

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 #1 hospital in Dallas-Fort Worth for the sixth consecutive year, we invite you to continue your healthcare career with us at William P. Clements Jr. University Hospital. You'll discover a culture of teamwork, professionalism, and consistent opportunities for learning and advancement into leadership roles

UT Southwestern is honored to be a Veteran Friendly work environment that is home to approximately 800 veterans.  We value your integrity, dedication, and the commitment you've made to our country.  We're proud to support your next mission. 

To learn more about the benefits UT Southwestern offers visit https://www.utsouthwestern.edu/employees/hr-resources/.

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.    

• Required three to five (3-5) years acute hospital-based coding experience. An equivalent combination of education and experience may be considered. Experience working in a remote environment preferred.
• Required Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT),  or AHIMA Certified Coding Specialist (CCS), or AAPC credential - Certified Professional Coder (CPC) (Prior to 2014); or Certified Outpatient Coder (COC)  (excludes AAPC Apprentice)
• Preferred Bachelor's Degree or Associate Degree in Health Information Management and/or closely related field

• 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

• Work requires strong analytical and critical thinking skills.
• Work requires excellent customer service, interpersonal, and communication skills (verbal and written).
• Work requires organizational skills along with a high level of accuracy and attention to detail.
• Work requires ability to report and problem solve using discretion, judgment, and professionalism.
• Work requires ability to handle multiple tasks, show initiative, and adjust to changes as appropriate under a stressful environment.
• Work requires ability to perform in a conservative, fast-paced, and quality driven environment.
• Work requires ability to comprehend, understand, and follow established policies, procedures, and other guidelines of some complexity.
• Work requires self-motivation, maturity, and being a team player.

This job is 100% remote.

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. 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. To learn more, please visit: https://jobs.utsouthwestern.edu/why-work-here/diversity-inclusion