H.I.M. Medical Records Analyst ROC FT

STHS-ROC
Edinburg, TX
Responsibilities

POSITION SUMMARY: Serves as a key liaison for Texas facilities: STHS, DHL, FDRMC, NWT and TMC between Atlantic CBO (ATCBO), Coding, Health Information Management (HIM), Revenue Cycle, and Ancillary departments for issues related to coding, claims, medical necessity edits, documentation compliance, and regulatory requirements. This role will directly resolve complex coding and claims issues by performing real-time corrections and collaborating across departments to ensure accurate, timely claim submission. The position will focus on Outpatient Code Editor (OCE/APC), National Corrective Coding Initiative (NCCI), and medical necessity edits while addressing DNFB resolution, audit support, and immediate corrective action for coding and claims issues across multiple facilities. Assists with DNFB initiatives to address and/or follow-up on Holds or aging accounts. Assists with audit reviews of OP accounts performed by AI or outsourced. Monitors and maintains appropriate reports as needed.

This position requires advanced coding expertise, decision-making authority, and strong collaboration skills to ensure that all coding and claims discrepancies are resolved in a timely manner to meet compliance, regulatory, and quality standards.

Qualifications

QUALIFICATIONS:

1. Excellent customer service skills required

2. Clinical, Health Information Management/Coding, or Patient Financial experience

3. Advance proficient in Microsoft Office applications and other data mining software with the ability to identify trends, recommend process improvements, and implement educational initiatives.

4. Advanced knowledge of ICD-10-CM, CPT, HCPCS, medical necessity guidelines, and Outpatient Code Editor (OCE/APC), NCCI, and Local Medical Review Policies (LMRP).

5. Understand Medicare & Medical assistance regulations as needed

1. Strong decision-making abilities and the capability to resolve complex coding and billing issues across multiple facilities.

2. Excellent communication and collaboration skills, with the ability to interact with senior leadership, clinical staff, and coding/billing teams.

3. Must demonstrate commitment and adherence to STHS’s Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.

EDUCATION / LICENSURE:

1. Associates Degree or above in Health Information Management or business related field; 6 years of Coding experience in a Healthcare setting may be considered in lieu of a degree.

2. Coding certification required, or obtained within 12 months of employment.

3. High School diploma, GED or Higher Education required.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-800-852-3449.

Authorized by

Corporate Human Resources

Posted 2025-09-06

Recommended Jobs

Lab | Lab Tech

Wood County, TX

Travel Medical Laboratory Technician (Lab Tech) Job – Wrangell, Alaska Advance your healthcare career with a travel Medical Laboratory Technician (Lab Tech) position in Wrangell, Alaska (zip code 9…

View Details
Posted 2025-08-23

Software Engineer, GCP, One Platform

Google
Sunnyvale, TX

Minimum qualifications: • Bachelor’s degree or equivalent practical experience. • 2 years of experience with software development in one or more programming languages (C, C++, Java, or Go). • 2 yea…

View Details
Posted 2025-08-27

Automotive Service Technician/Mechanic

Finnegan Chevrolet Buick GMC
Rosenberg, TX

At Finnegan Auto Group we believe our employees are our greatest asset. As such, we treat all employees with respect and appreciation for their contributions to the company. We believe not only in pro…

View Details
Posted 2025-08-28

Junk Removal Specialist

College Hunks Hauling Junk & Moving
Coleman County, TX

To be one of the H.U.N.K.S., you must be: Honest, Uniformed, Nice, Knowledgeable, and Service-oriented.  Come and see what all the buzz is about and join our winning team. College Hunks Hauling Junk…

View Details
Posted 2025-08-23

Sales Associate

Hublot
Dallas, TX

Hublot is seeking a Sales Associate in Dallas to play a pivotal role in achieving boutique success through exceptional customer service and sales target achievement. The role demands a professional wi…

View Details
Posted 2025-08-23

$17/HR - Warehouse Forklift Operator- (Stand Up Reach) Lewisville, TX

Belmar Integrated Logistics
Lewisville, TX

Full-Time Warehouse Stand- up Reach Forklift Operator   Schedule : Monday - Friday - Over 40+ Hours/Week (7am - Until Finish)  Pay-Rate: $17.00/HR Health/Dental/Vision Insurance is A…

View Details
Posted 2025-08-29

Outside Sales Clean Water Specialist

Aqua Clear Water Solutions
Mcallen, TX

Job Description Job Description Benefits/Perks Competitive Compensation Paid Time Off Career Growth Opportunities   Job Summary We are seeking a highly motivated and energetic Out…

View Details
Posted 2025-07-29

Millwright/Service Technician

Martin Engineering
Stafford, TX

Celebrating our 81st year, Martin Engineering is a privately owned global manufacturing company located in Neponset, IL.  A leader in our industry, we believe it is our people who are responsible f…

View Details
Posted 2025-07-30

BILINGUAL INSURANCE AGENT TRAINEE - Spanish

Farmers Insurance - Saydi Vasquez De Tome
Pflugerville, TX

We are looking for individuals that are looking to enter the financial lucrative world of insurance! Our producer program allows you to work and be mentored by one of our districts most successful ag…

View Details
Posted 2025-09-02

Senior Product Manager (Derivatives)

Crypto.Com
Dallas, TX

Our Product Management team drives product initiatives from inception through execution, makes impacts and launches products/features across our global footprint. We collaborate closely with engineer…

View Details
Posted 2025-09-14