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Medicare Coding Jobs in Texas (NOW HIRING)

University Health

Coding Educator

San Antonio, TX · On-site

$25.10 - $40.25/hr

Trains new Coding Specialist(s), Technician(s), and Associate(s). Promotes the Health System ... Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ...

University Health

Coding Educator

San Antonio, TX · On-site

$25.10 - $40.25/hr

Trains new Coding Specialist(s), Technician(s), and Associate(s). Promotes the Health System ... Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS ...

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Medicare Coding information

Are medical coders still in demand?

Medical coders, including those specializing in Medicare coding, are in steady demand due to the ongoing need for accurate medical billing and coding in healthcare. The role requires knowledge of coding systems like ICD-10 and CPT, and job prospects remain strong as healthcare providers seek compliance and reimbursement efficiency.

Will AI eventually replace medical coders?

Medicare coders use specialized knowledge to assign codes based on medical records, and while AI tools can assist with coding accuracy and efficiency, they are unlikely to fully replace human coders in the near future due to the need for clinical judgment and understanding of complex cases. Coders will continue to play a vital role in ensuring correct billing and compliance, often working alongside AI systems. Ongoing training in coding standards and technology is important for job security in this evolving field.

What is the difference between Medicare Coding vs Medical Billing?

AspectMedicare CodingMedical Billing
Primary FocusAssigning medical codes for Medicare claimsProcessing and submitting insurance claims
CertificationsMedical Coding Certification (e.g., CPC)Billing and coding certifications often preferred
Work EnvironmentHospitals, clinics, insurance companiesMedical offices, billing companies, hospitals
Industry UsageUsed mainly in Medicare and insurance claimsUsed across various insurance providers

Medicare Coding involves assigning specific codes to medical procedures and diagnoses for Medicare claims, focusing on accurate coding for reimbursement. Medical Billing encompasses the broader process of submitting claims, following up on payments, and managing patient billing. While they overlap, Medicare Coding is more specialized in coding accuracy for Medicare, whereas Medical Billing covers the entire billing cycle across multiple insurers.

What are the key skills and qualifications needed to thrive as a Medicare Coder, and why are they important?

To thrive as a Medicare Coder, you need a solid understanding of medical terminology, ICD-10-CM and CPT coding systems, and compliance with Medicare regulations, often supported by certification such as CPC or CCS. Proficiency with coding software, electronic health records (EHRs), and claims submission systems is typically required. Attention to detail, analytical thinking, and strong organizational skills help coders accurately interpret clinical documentation and manage complex billing requirements. These skills are essential to ensure accurate reimbursement, reduce claim denials, and maintain compliance with federal healthcare regulations.

What is Medicare coding?

Medicare coding refers to the process of assigning standardized codes to medical diagnoses, procedures, and services for patients covered under Medicare. These codes, such as ICD-10, CPT, and HCPCS, are used to ensure accurate billing and reimbursement from the Centers for Medicare & Medicaid Services (CMS). Proper Medicare coding is crucial for healthcare providers to receive correct payment and to comply with federal regulations. Coders must stay up to date with frequent changes in coding guidelines and Medicare policies.

What are some common challenges faced by professionals in Medicare coding, and how can these be managed effectively?

Medicare coding professionals often encounter challenges such as keeping up with frequent regulatory updates, accurately interpreting complex medical documentation, and ensuring compliance with strict billing guidelines. To manage these effectively, it’s important to participate in ongoing training, regularly review CMS updates, and utilize coding tools and resources. Collaborating closely with healthcare providers and billing teams can also help ensure accurate and timely claim submissions, reducing the risk of denials or audits.

What is the highest paid Medical Coder?

The highest paid medical coders are often those specializing in inpatient hospital coding, such as Certified Professional Coders (CPC) with additional credentials or experience in complex coding environments. Senior or specialized roles, including coding managers or auditors, can earn salaries exceeding $80,000 annually, especially with advanced certifications and extensive experience.

How to become a Medicare reviewer?

To become a Medicare reviewer, typically one needs a background in healthcare, such as nursing, medical coding, or health administration, along with knowledge of Medicare policies. Certification in medical coding (e.g., CPC, CCS) and familiarity with Medicare guidelines are often required, and experience in claims review or auditing can be beneficial.
What are popular job titles related to Medicare Coding jobs in Texas? For Medicare Coding jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Medicare Coding jobs in Texas look for? The top searched job categories for Medicare Coding jobs in Texas are:
Medicare Coding jobs near you
Ambulatory Payment Classification Coordinator

Ambulatory Payment Classification Coordinator

Houston Methodist

Katy, TX

$20.75 - $27.75/hr

Full-time

Posted 6 days ago

Houston Methodist rating

8.1

Company rating: 8.1 out of 10

Based on 296 frontline employees who took The Breakroom Quiz

68th of 882 rated healthcare providers

Job description

At Houston Methodist, the Ambulatory Payment Classification (APC) Coordinator position is responsible for reviewing and correcting all claims edits related to the APC grouper, National Correct Coding Initiative (NCCI), Correct Coding Initiative (CCI), etc. This position reviews Current Procedural Terminology Fourth Edition (CPT-4)/Healthcare Common Procedure Coding System (HCPCS) code errors and communicates with key operational staff/stakeholders to ensure proper coding, charging, and compliant claims. FLSA STATUS
Exempt
QUALIFICATIONS
EDUCATION
  • High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
  • Bachelor's degree preferred

EXPERIENCE
  • Two years of coding experience
  • One year of revenue cycle experience preferred

LICENSES AND CERTIFICATIONS
Required
  • Must have one of the following:RHIT - Certified Health Information Technician (AHIMA)RHIA - Registered Health Information Administrator (AHIMA)CCS - Certified Coding Specialist (AHIMA)CCA - Certified Coding Associate (AHIMA)CCS-P - Certified Coding Specialist Physician-Based (AHIMA)CPC - Certified Professional Coder (AAPC)CPC-H - Certified Professional Coder - Hospital (AAPC)CPC-I - Certified Professional Coder Instructor (AAPC)CPC-A - Certified Professional Coder Associate (AAPC)CCC - Certified Cardiology Coder (AAPC)COC - Certified Outpatient Coder (AAPC)

SKILLS AND ABILITIES
  • Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
  • Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
  • Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
  • Knowledge of patient account charge processes and a comprehensive understanding of Medicare coding rules and regulations
  • Ability to follow-through and handle multiple tasks simultaneously
  • Ability to work independently and interdependently with other business office staff
  • Sharp analytical abilities in order to ensure proper coding and charging of related accounts
  • Proficient computer skills and ability to learn and navigate multiple software programs
  • Expert knowledge of the various state and federal insurance programs
  • Ability to partner with various hospital departmental colleagues
  • Knowledge of International Classification of Diseases (ICD) coding (procedure and diagnoses), CPT and HCPCS
  • Knowledge of correct charging practices for non-Medicare carriers

ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
  • Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal department and organizational results.
  • Collaborates with key stakeholders to address discrepancies with charges and medical records documentation.
  • Addresses billing and coding edit issues that require specialized analyses; triages issues to Charge Description Master (CDM) team, medical records coding, or other revenue cycle partners as necessary.

SERVICE ESSENTIAL FUNCTIONS
  • Reviews charges and medical records to ensure that claims are billed compliantly and are supported by medical record documentation. Communicates to management about barriers to compliant and accurate billing including medical record issues, department charging practices, etc.
  • Recommends changes as needed to the Charge Description Master.
  • Responds to referrals and customers with resolutions within the expected time frame.
  • Trains department and revenue cycle staff as needed on regulatory items related to compliant coding on the claim.

QUALITY/SAFETY ESSENTIAL FUNCTIONS
  • Meets or exceeds stated departmental standards for Key Performance Indicators (KPI) (e.g., inventory management, productivity, quality reviews, etc.).
  • Follows established coding rules and guidelines based on accurate documentation in the medical record when reviewing claims.
  • Incorporates federal and state regulations, payor medical policies, case specific medical documentation, and claims information into claims review for timely and compliant billing.

FINANCE ESSENTIAL FUNCTIONS
  • Analyzes data from various sources (medical records, claims data, payor medical policies, etc.), determines the causes for coding related edits or denials and partners with management to ensure timely billing and denial prevention.
  • Analyzes APC/claim edits/coding denials to identify new trends, opportunities, and educational feedback as needed.
  • Follows levels of authority for posting adjustments, refunds, and contractual allowances.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS
  • Actively engages in personal assessment and expands learning beyond baseline competencies with a focus on continual development (i.e., participates in training opportunities, focal point review activity, etc.). Applies new learning.
  • Stays current on all federal and state regulations related to NCCI/CCI/APC and related edits.

SUPPLEMENTAL REQUIREMENTS
    WORK ATTIRE
    • Uniform: No
    • Scrubs: No
    • Business professional: Yes
    • Other (department approved): Yes

    ON-CALL*
    *Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
    • On Call* No

    TRAVEL**
    **Travel specifications may vary by department**
    • May require travel within the Houston Metropolitan area No
    • May require travel outside Houston Metropolitan area No

Work Shift:

1 - Day (United States of America)

Job Category:

Non-clinical Houston Methodist is one of the nation's leading health systems and academic medical centers. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. Come lead with us!

Houston Methodist is an Equal Opportunity Employer.

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