Coding Quality Assurance Specialist III Hospital Billing DRG

Position: Coding Quality Assurance Specialist III Hospital Billing DRG

Job ID: 157532

Location: US-TX-Houston


Talent Area: Clerical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: Days

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 14,000+ dedicated team members, visit for career opportunities. You can also learn more about our amazing culture at   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.


We are searching for a Coding Quality Assurance Specialist (III) - Hospital Billing DRG - someone who works well in a fast-paced setting. In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. You will also ascertain the accuracy of the physicians' E/M and procedure coding to their documentation and complete the auditing reporting tool and provide this feedback to the education team and/or provider. You may perform only certain parts of the following responsibilities depending on their particular work assignment.

Think you’ve got what it takes?

Responsibilities :

  • Assign ICD-10-CM, ICD-10-PCS, and/or CPT codes
  • Review and interpret physician documentation to appropriately assign diagnosis and procedure codes
  • Complete abstracts for records as appropriate
  • Check discharge disposition and attending physician for correctness
  • Assist in correction of problem accounts
  • Identify incorrect admit/discharge dates and patient types
  • Review charts for completeness
  • Identify and report charts requiring operative reports or with documentation
  • Participate in education and maintain certification
  • Facilitate coding education sessions (webinars, audio conferences, seminars, lunch and learn, newsletters) by researching and presenting topics assigned by manager each month
  • Assist in auditing records
  • Participate in peer coding reviews as necessary
  • Maintain concurrent coding for inpatient records
  • Assign diagnosis and procedure codes for patients in-house


  • High school diploma or equivalent required
  • Health Information Tech certification required
  • 4 years’ coding experience required
  • One of the following certifications is required: CCA, CCS, CCS-P, CIPC, COC, CPC, CRC, RHIA
  • Experience using an encoder or electronic medical records preferred

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