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 2025-09-21

Recommended Jobs

Quality Assurance IT Inspector

Insight
Texas

Quality IT Inspector Location:  This role is fully onsite in our Fort Worth, TX office. Hours: 10:30 am - 7 pm  Duration: 40 hours per week. Potential to convert to full time. Now …

View Details
Posted 2025-08-22

GTM Lead, Retail & Commerce AI (AI Infra)

Lavendo
Austin, TX

Job Description Job Description About the Company Our client is a leading AI infrastructure provider operating a full-stack cloud platform designed for intensive AI workloads. The company feat…

View Details
Posted 2025-07-29

Project Engineer

Channelview, TX

  Project Engineer opportunity with Traylor Bros., Inc.!   Traylor Bros., Inc. (TBI) National Heavy Civil division provides comprehensive, cutting-edge heavy civil/underground construction services…

View Details
Posted 2025-09-16

Team Member/Closing Grill Cook

Hawaiian Bros Island Grill - Stine Ventures LLC Alliance, TX
Fort Worth, TX

Job Description Job Description At Hawaiian Bros, we embody the Aloha spirit so we can help inspire our guests to do the same. That means ensuring a healthy work-life balance that lets you live i…

View Details
Posted 2025-07-30

CARILLON PM SERVER ASSISTANT (FULL TIME)

Compass Group
Austin, TX

  We are hiring immediately for a full time CARILLON PM SERVER ASSISTANT position. Location : University of Texas - 1900 University Ave, Austin, TX 78705. Note: online applications accepted …

View Details
Posted 2025-08-22

“Texas Charm Meets Healthcare: OT Opportunity in Childress!”

NurseRecruiter
Childress, TX

Occupational Therapist Long Term Acute Care job in Childress, TX Discover the charm of Childress, Texas, while advancing your career as an Occupational Therapist! This in-patient rehab opportunity al…

View Details
Posted 2025-07-30

Lead Document Controller

Sempra LNG
Houston, TX

Lead Document Controller Location Houston, TX (West Houston area) : Primary Purpose Lead document control team for LNG & Net Zero project. Responsible for hiring and time management of contractor reso…

View Details
Posted 2025-09-22

Senior Data Analyst

Sansar Tec Llc
Houston, TX

Description: Position: Senior Associate Data Analyst Location: Remote Responsibilities:  • Perform complex data analysis and employ advanced data analytics techniques to derive actionable insi…

View Details
Posted 2025-09-14

Senior Backend Software Engineer

Way
Austin, TX

Headquartered in Austin, Texas, with its EMEA HQ in Paris, Way is the category-leading B2B technology for brands to unlock the extraordinary power of experiences. In a world where 76% of consumers wo…

View Details
Posted 2025-09-14

Accounts Payable Clerk in Alvarado, TX

Thalle Construction Company
Alvarado, TX

Accounts Payable Clerk Office Location: ONSITE Alvarado, TX  Job Title : Accounts Payable Clerk Thalle Construction Co. Inc. (“Thalle”) is seeking an Accounts Payable Clerk. We are lo…

View Details
Posted 2025-09-14