Coding & Documentation Specialist
Coding & Documentation Specialist
- 513239
- Remote, Texas, United States
- Staff
Title: Coding & Documentation Specialist
Employee Classification: Coding & Doc Specialist
Campus: University of North Texas - Health Science Center
Division: HSC-Health Systems
SubDivision-Department: HSC-Health Systems & Clinical Aff
Department: HSC-HSC Health Administration-335001
Job Location: Fort Worth
Salary: commensurate with experience
FTE: 1.000000
Retirement Eligibility: TRS Eligible
About Us - Values Overview
Department Summary
UNT Health is the academic clinical practice of the University of North Texas Fort Worth campus, where quality care meets quality education.
UNT Health primary and multispecialty care offices are located on the UNT Health Fort Worth, Denton and Dallas UNT System campuses, focusing on improving health outcomes to build healthier communities.
Care includes mobile health initiatives and extends to hospitals, surgery centers, long-term/continuing care centers, and in-home care.
UNT Health’s interprofessional teams work collaboratively to achieve an optimized treatment plan tailored to the individual patient.
Physicians, neurologists, nurse practitioners, pharmacists, social workers, psychologists, nurses and more work together while intentionally integrating healthcare students, residents, and fellows to deliver care to our community.
Position Overview
The Coding and Documentation Specialist is responsible for accurately assigning appropriate diagnostic and procedural codes to patient health information to support data retrieval, analysis, reimbursement, and regulatory compliance. This role also includes reviewing, analyzing, and entering charges into the practice management system while ensuring adherence to established standards, concepts, and coding guidelines.
In addition, the specialist will verify patient benefits and eligibility, obtain required authorizations and referrals, perform timely follow-up on pending or denied requests and claims, and collaborate with clinical and administrative teams to ensure complete and accurate documentation that supports optimal claim processing and revenue cycle outcomes.
Minimum Qualifications
Bachelor's degree or equivalent combination of education and experience.
Knowledge, Skills and Abilities
- Knowledge of ICD-9/10 CM, HCPC, and CPT coding systems and how to apply them accurately to medical records.
- Familiarity with medical documentation standards, coding guidelines, and regulatory requirements for billing.
- Understanding of healthcare billing processes and the importance of accurate coding for compliance and reimbursement.
- Strong attention to detail to ensure accurate coding and to identify clinical activities that need billing information.
- Excellent communication skills to work effectively with providers, address discrepancies, and clarify diagnosis or procedure codes.
- Proficiency in reviewing and validating medical records and claims to ensure compliance with coding and documentation requirements.
- Ability to resolve coding and documentation issues promptly in a clinic environment, ensuring timely billing and compliance.
- Strong problem-solving skills to address and correct coding mismatches or errors in collaboration with providers.
Preferred Qualifications
- NextGen experience
Required License/Registration/Certifications
- CPC Certification
Job Duties
- Communicate with management personnel about any coding or billing matters that may place the organization or individual provider at risk for non-compliance. If necessary, takes that issue up the management chain to reach a resolution.
- In a clinic and business environment, answers questions and resolves coding and documentation issues in real time.
- Abstracts clinical information form a variety of medical records to assign appropriate ICD10CM, HCPCS and/or CPT codes to patient records.
- Reviews claims prior to submission to assure that they are complete, accurate, and in compliance with coding and documentation requirements.
- Communicates effectively with providers to improve coding and ensure documentation supports the codes assigned. Keep all assigned providers updated with changes in coding or documentation requirements, changes in insurance plan policies or other changes that may affect reimbursement.
- Keep billing and coding knowledge accurate, complete, and current.
- Work denied claim reports to correct and either rebill or appeal claims in a timely manner to ensure timely filing and appeal deadlines are met.
- Review claim denials for billing and payer processing accuracy. Contact insurance payers regarding claim denials for reprocessing.
- Stay current on insurance payer billing guidelines and changes.
- Verify patient insurance eligibility and benefits information.
- Obtain and maintain current insurance prior authorizations for upcoming patient appointments.
- Maintain current insurance referrals.
- Performs other duties as assigned to meet the ongoing needs of the Department.
Physical Requirements
- Repeating motions that may include the wrists, hands and/or fingers.
- Sedentary work that primarily involves sitting/standing.
- Communicating with others to exchange information.
Environmental Hazards
- No adverse environmental conditions expected.
Work Schedule
Monday - Friday, 8am to 5pm
Driving University Vehicle
No
Security Sensitive
This is a Security Sensitive Position.
Special Instructions
Applicants must submit a minimum of two professional references as part of their application. If needed, additional references can be added after the application has been submitted.
Benefits
For information regarding our Benefits, click here.
EEO Statement
The University of North Texas System is firmly committed to equal opportunity and does not permit –and takes actions to prevent – discrimination, harassment (including sexual violence, domestic violence, dating violence and stalking), and retaliation on the basis of race, color, religion, national origin, sex, age, disability, genetic information, or veteran status in its application, employment practices, and facilities; nor permits race, color, national origin, religion, age, disability, veteran status, or sex discrimination and harassment in its admissions processes, and educational programs and activities. UNT System Administration promptly investigates complaints of discrimination, harassment, and related retaliation and takes remedial action when appropriate. System Administration also takes actions to prevent retaliation against individuals who oppose any form of harassment or discriminatory practice, file a charge or report, or testify, assist, or participate in a related investigation or proceeding.
