Medical Coding Auditor

Texas Tech University•El Paso, TX

About The Position

The Medical Coding Auditor audits medical records to ensure accurate coding and documentation and compliance with regulatory requirements, healthcare laws, payer policies, and organizational rules. The role supports continuous quality improvement in coding practices and provides education to practices, providers, and departmental leaders based on audit findings and current CMS regulations. The auditor works directly with the Medical Coding Auditor Manager to implement best practices that improve coding accuracy, maximize revenue, and meet regulatory requirements. The position also supports revenue-cycle and billing strategies, monitors post-audit corrective actions, and collaborates across teams to address findings, maintain compliant claims data transfers, and improve processes. Compensation is based on the selected candidate’s qualifications and the hiring department’s budgetary guidelines and institutional pay plan. TTEP is not considering applicants who require employment-visa sponsorship, including H-1B visa holders and individuals currently on student or postgraduate visas.

Requirements

Bachelor’s degree in business, public administration, or a related field, with one year of related experience; alternatively, a combination of education and/or related experience totaling five years.
At least two years of relevant audit experience in physician or facility medical coding, auditing, or compliance roles.
Current CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CBCS (Certified Billing and Coding Specialist) certification.

Nice To Haves

Five years of relevant audit experience in physician or facility medical coding, auditing, or compliance roles.
Prior experience reviewing medical records for coding accuracy and regulatory compliance in an academic medical or health sciences center.

Responsibilities

Review and audit medical records for ICD-10-CM, CPT, and HCPCS coding accuracy and documentation compliance.
Ensure compliance with federal, state, CMS, payer-specific, and organizational requirements.
Identify coding discrepancies and recommend corrective actions.
Prepare detailed audit reports and provide feedback on documentation and coding practices.
Collaborate with relevant departments to resolve audit findings and maintain ongoing compliance.
Stay current with coding guidelines, healthcare regulations, and payer policies.
Assist in developing and refining audit tools, policies, and procedures.
Monitor and track post-audit corrective actions and follow up to resolve identified issues.
Ensure the accuracy of abstracted data affecting reimbursement across clinical locations, including discharge disposition, indicators, and procedure dates of service.
Follow physician and facility coding guidelines, policies, and procedures as needed.
Lead coding and charge-posting team communications, huddles, and projects, and communicate KPI requirements established by the Medical Coding Auditor Manager.
Participate in developing coding and billing strategies, evaluate revenue-cycle processes, and make recommendations while ensuring compliance with applicable rules and regulations, including HIPAA, Medicaid, Medicare, and third-party payer requirements.
Collaborate with appropriate teams to ensure claims data is transferred appropriately through the clearinghouse.
Maintain professional relationships across teams; manage projects, facilitate meetings, and present in various settings, including to senior leadership.
Maintain required licensure and certifications and complete mandatory compliance requirements and training.
Adhere to applicable institutional policies, procedures, and practices, including Regents Rules, TTUS, and HSCEP OPs.
Demonstrate TTUHSC EP’s values of Service, Respect, Accountability, Integrity, Advancement, and Teamwork, and promote these values across the institution.
Perform other duties as assigned.