Coding/Compliance Denials Analyst

UT Southwestern Medical Center • Dallas, TX

1d • Onsite

About The Position

Develops outpatient coding education. Research complex outpatient coding denials. Conducts risk-based coding compliance audits and ad hoc audits of outpatient encounters to validate code assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record and payer guidelines.

Requirements

• 5 years of coding experience including but not limited to hospital outpatient encounters
• 5 years of experience in coding audit or quality review work including but not limited to outpatient encounters
• 1 year of experience preparing and delivering education as it relates to audit findings or regulatory guidance to coders and auditors
• (CPC) CERT PROFESSIONAL CODER Upon Hire or
• (CPMA) Cert Prof Medical Auditor Upon Hire or
• (CEMC) Certified E/M Coder Upon Hire or
• (CPC-I) AAPC Approved Instructor Certification Upon Hire

Nice To Haves

• Bachelor's Degree in relevant field preferred or combination of equivalent of education and experience

Responsibilities

• Develops outpatient coding education via spreadsheet.
• Research complex outpatient coding issues related to questions, inquiries, and investigations.
• Understands, interprets, and applies coding guidelines for risk-based audits.
• Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating Coders, Auditors, Managers, and Directors throughout the organization.
• Identifies documentation issues (lacking documentation, missed physician queries, etc.) that impact coding accuracy. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS, AAPC and other agency directives for ICD-10-CM and CPT coding. Completes online education courses and attends mandatory coding workshops and/or seminars (OPPS ICD-10-CM, and CPT updates) for outpatient coding. Reviews AHA and CPT quarterly coding update publications. Attends all internal conference calls for Quarterly Coding Updates.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree