Position Title:

Professional Coding Specialist II

Department:

Revenue Integrity

Job Description:

Ask your recruiter about our competitive wages and total rewards package!

Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.

General Description

Independently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.

Essential Job Duties

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.

Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD‑10‑CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.
Resolve coding-related edits and denials by identifying root cause, coordinating documentation clarification, and supporting rebilling actions as applicable.
Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules as relevant to pro fee claims.
Provide real‑time guidance to peers on standard coding scenarios; promote consistency through best‑practice sharing.
Participate in internal quality review programs and implement education/corrective actions based on findings.
Proficiency in Epic professional coding work queues and encoder tools; ability to efficiently review documentation in the EHR across settings.
Analytical problem solving for denial/edits prevention; ability to identify documentation improvement opportunities and support compliant query workflows
Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations.

General Job Duties

Performs other duties as assigned

Education: High School diploma or GED required.

Experience: At least 3 years of experience physician/provider coding required.

Certification/License/Registration: CPC or CCS-P required

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.