Join us as a Coding & Charge Integrity Specialist to play a crucial role in ensuring accurate billing processes that support our organization's mission of delivering exceptional healthcare services!

Coding & Charge Integrity Specialist Department:

Revenue Cycle Management Reports To:

Revenue Cycle Director FLSA Status:

Exempt or Non-Exempt (per organizational policy)

Location:

Onsite - Arlington, Texas Position Summary The Coding & Charge Integrity Specialist works alongside the organization's AI/outsourced coding vendor to close the operational gaps that automated and remote coding cannot fully cover. This role is the point of accountability for identifying missing charges, resolving coding-related denials, and validating that charges generated by the AI coding platform accurately reflect the documentation and services rendered. The position acts as the liaison between clinical staff, the coding vendor, and the billing/revenue cycle team to ensure charges are captured completely, coded accurately, and submitted without unnecessary delay. This role is not intended to replace the AI coding vendor's output but to supervise, validate, correct, and escalate — catching what automated coding and remote review miss, particularly items that require on-the-ground clinical or workflow context (open encounters, unsigned notes, missing charge entries, provider queries, and payor-specific denial patterns). Key Responsibilities Monitor daily/weekly missing encounter and open encounter reports (e.g., Audit Encounters, Missing Encounters Report) to identify unsigned notes, unbilled visits, and charges that never left the EHR. Work directly with providers and clinical staff to resolve documentation gaps causing missing charges (e.g., unsigned notes, incomplete encounters). Reconcile scheduled/completed appointments against billed encounters to catch charges that fell out of the workflow. Track charges sitting in pre-billing edit queues (tasking edits, RCx platform, unbilled vouchers, failed validations) and route them for correction before they age. Review and work coding-related denials (e.g., CO-252 medical necessity/records requests, CCI edits, bundling, modifier issues, incorrect code selection) received from payors. Validate AI vendor-generated codes against source documentation when a denial suggests a coding discrepancy; correct and resubmit as appropriate. Identify recurring denial patterns by payor, code, or provider and report trends to the coding vendor and revenue cycle leadership for root-cause correction. Prepare or support appeal documentation for coding-related denials, including compiling supporting clinical records. Serve as the subject matter expert validating AI-coded claims for accuracy prior to or shortly after submission, particularly on high-risk/high-dollar procedures. Spot-check a sample of AI-generated codes against clinical documentation on a regular cadence to monitor coding accuracy and flag systemic errors back to the vendor. Escalate documentation ambiguities to providers when the AI coding engine cannot code confidently from the note (missing specificity, laterality, etc.). Maintain a feedback loop with the coding vendor — logging error patterns, disputed codes, and turnaround issues. Act as the liaison between clinical staff, front desk/scheduling, the billing team, and the remote/AI coding vendor. Communicate documentation or workflow changes needed to reduce missing charges and denials (e.g., provider feedback/education on documentation specificity). Participate in charge capture and denial trend meetings with revenue cycle leadership. Maintain and report on key metrics: missing charge volume/aging, denial rate by category, coding accuracy rate, and charge lag (date of service to charge submission). Provide regular summaries to leadership on trends, root causes, and process improvement recommendations. Required Qualifications High school diploma or equivalent required; associate's degree in health information management, Medical Billing/Coding, or related field preferred.

Active coding credential required:

CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or equivalent (AAPC or AHIMA certified). Minimum 2-3 years of medical coding and/or denial management experience, preferably in a specialty setting (e.g., surgical, procedural specialties). Working knowledge of ICD-10-CM, CPT, and HCPCS coding systems. Familiarity with payor medical necessity requirements and common denial reason codes (e.g., CO-252, CO-50, CO-97, CO-16). Experience working within an EHR and practice management system (e.g., Veradigm/Allscripts, Epic, athenahealth, or similar). Strong understanding of medical terminology, coding guidelines, ability to fully interpret and understand payor-related policies and coverage guidelines. Preferred Qualifications Prior experience working alongside or auditing output from an AI/automated coding platform or outsourced coding vendor. Experience in the relevant specialty (e.g., urology, orthopedics, IR, ENT) with knowledge of specialty-specific documentation and coding nuances. Experience with clearinghouse tools (e.g., PayerPath) and charge/claim workflow platforms (e.g., Curve, RCx). Familiarity with payor appeal processes for medical necessity denials. Skills & Competencies Strong attention to detail and comfort working with high volumes of claims/charge data. Ability to read and interpret clinical documentation (op notes, H&Ps, progress notes) to validate coding accuracy. Comfortable interfacing directly with physicians and clinical staff to resolve documentation gaps. Analytical mindset — able to identify patterns in denials/missing charges and translate them into process fixes rather than one-off corrections. Strong working knowledge of Excel/reporting tools for tracking metrics. Effective communicator across clinical, billing, and vendor teams. Strong organizational skills.

Pay:

$58,000.00 - $75,000.00 per year

Benefits:

401(k) Dental insurance Employee assistance program Health insurance Paid time off Retirement plan Tuition reimbursement Vision insurance

Experience:

Medical coding: 2 years (Required)

License/Certification:

Certified Professional Coder, Certified Coding Specialist (Preferred)

Work Location:

In person