Coding Specialist III

Why UT Southwestern? With over 75 years of excellence in Dallas‑Fort Worth, 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, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package includes healthcare, PTO and paid holidays, on‑site childcare, wage merit increases and more. Job Summary UT Southwestern Medical Center has an opportunity within the Revenue Cycle Department for the role of Coding Specialist III. The position works under general supervision to perform advanced, accurate, and compliant coding of high‑complexity surgical, procedural, and interventional specialties within a highly specialized academic medical center environment. The applicant exercises independent judgment in reviewing encounters characterized by high documentation variability, evolving intraoperative findings, multi‑procedure operative cases, complex bundling and add‑on logic, advanced payer nuance and regulatory interpretation, device‑intensive procedures, and more. Key Responsibilities Codes and audits patient encounters to ensure accurate documentation. Codes for the OBGYN department. Understanding governmental and payer policies when it comes to coding guidelines. Meets productivity and quality standards set by coding leadership. Reviews and validates high‑complex physician encounter documentation in Epic to ensure accurate and compliant ICD‑10‑CM, CPT and HCPCS code assignment before claim submission. Identifies and mitigates compliance risks associated with high‑complexity encounters, including interdependent diagnoses, high‑risk procedures, split/shared and incident‑to services, and teaching physician documentation. Supports multiple specialties in a hybrid role as needed. Reviews and resolves coding‑related edits, including NCCI bundling conflicts, modifier application, MUE limits, payer‑specific requirements, and global surgical package considerations. May evaluate, accept, modify, or override AI‑generated coding outputs from Epic AI Code Assist, AI E&M LOS Assistant, and third‑party platforms using advanced clinical and regulatory judgment. Resolves AI exception flags, documentation discrepancies, and code conflicts to ensure audit readiness and clean claim release. Analyzes recurring coding edits, AI variances, and denial trends, performs root‑cause review, and communicates findings to leadership when systemic issues are identified. Collaborates with providers to clarify documentation and ensure accurate code capture that supports medical necessity and reimbursement. Supports denial prevention efforts by partnering with billing and denial management teams to resolve coding‑related rejections and underpayments. Maintains advanced knowledge of ICD‑10‑CM, CPT, HCPCS, payer policies, LCD/NCD guidelines, and regulatory updates. Participates in internal audits, quality assurance initiatives, Epic upgrades, and AI workflow optimization projects. May function in a float capacity, providing coding support to maintain operational coverage and productivity standards. Adheres to all organizational policies, compliance standards, data security requirements, and performance expectations; performs additional duties as assigned. Performs other duties as assigned. Experience and Education Required High school diploma or GED equivalent. Four years of coding and/or billing experience. Preferred Experience coding high‑complexity specialties and procedures requiring advanced bundling, modifier logic, and payer‑specific rule application. Progressive professional billing and coding experience and advanced technical proficiency. Experience in academic medical centers, multi‑specialty physician groups, or complex ambulatory environments. Experience resolving charge review edits, back‑end coding denials, root‑cause analysis, and collaboration with providers and operational leaders. Experience supporting revenue integrity initiatives, compliance auditing, clinical documentation improvement, or operational performance improvement. Experience working independently in a fast‑paced, metric‑driven, AI‑enabled environment managing multiple work queues and shifting specialty assignments. Licenses and certifications: CPC, CCS‑P, PHY BA, CMC, RHIA, RHIT, CPMA, or similar. Benefits 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. Physical Demands / Working Conditions Repetitive motions; sitting. Indoor office setting. Security and EEO Statement This position is security‑sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. The holder must maintain the security or integrity of critical infrastructure as defined in Section 113.001(2) of the Texas Business and Commerce Code; it is a minimum qualification for hire and continued employment. 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. #J-18808-Ljbffr