Revenue Integrity Educator II - Revenue Cycle

UT Southwestern Medical Center • Dallas, TX

17h • Remote

About The Position

UT Southwestern is actively seeking an experienced Revenue Integrity Educator II to join our Revenue Cycle Front End team. We are looking for someone with strong surgical coding experience in specific specialties, initiative, and technology savviness. Epic experience is strongly preferred. Certification as a Certified Professional Coder (CPC) is required; CPMA highly preferred but not required. The role requires experience and confidence in educating providers on proper coding, conducting provider audits across surgical specialties, and developing educational materials. The ability to communicate professionally with providers and all personnel is essential. As a Revenue Integrity Educator II, you will play a key role in advancing coding accuracy and billing compliance, educating providers on proper coding practices, conducting audits across surgical specialties, and developing impactful training materials. You’ll collaborate with Revenue Cycle and Compliance teams, support provider onboarding, and perform documentation and charge reviews to ensure regulatory alignment. This role is ideal for a detail-oriented coding professional with strong communication skills, surgical coding expertise, and a passion for education. If you have at least 5 years of coding and auditing experience and hold a CPC, CCS, CMC, or CPMA certification (Epic experience preferred), we encourage you to apply. This is a Work From Home (WFH) position, requiring the candidate to live within Texas. The preferred candidate lives in the DFW area. Candidates living out of state cannot be considered. The shift requirement is an 8-hour flex shift, Monday through Friday.

Requirements

• High School Diploma or equivalent.
• 5 years experience in a professional billing environment with emphasis on coding, auditing and compliance responsibilities.
• Certification as a Certified Professional Coder (CPC) is required.
• Strong surgical coding experience in one of these specialties: Ophthalmology, OB/GYN, Ortho, Neurosurgery, Otolaryngology, Spine, Urology, and/or Plastic.
• Initiative taking, Technology savvy.
• Experience and confidence with educating providers regarding proper coding.
• Ability to complete provider audits on different surgical specialties and communications with the Revenue Cycle teams and leaders.
• Experience with developing educational material.
• Ability to communicate professionally with providers and all personnel.
• Must live within Texas.

Nice To Haves

• Epic experience is strongly preferred.
• CPMA highly preferred but not required.
• Associate's Degree or two years of college.
• CPMA (Cert Prof Medical Auditor) Upon Hire certification.

Responsibilities

• Serves as a professional billing integrity leader, under supervision of Sr. Professional Billing Integrity Educator or Supervisor, to develop and conduct individual or group presentations on coding, billing and compliance topics, based on new regulatory and professional coding industry information; pre-bill professional charge review findings; University-identified risk areas, or special projects requested by MSRDP leadership. This may include medical record audits, invoice analysis, and review of internal reports (e.g., Charge Analyzer, Code Correct), denials, external audit findings, etc.
• Assists Sr. Professional Billing Integrity Educator or Supervisor with development and deployment of any action plans required.
• Conducts standardized new provider coding and compliance training ("onboarding") for physicians, advanced practice providers and other professional practitioners, in two or more service lines/divisions. Training may be conducted in an individual or group setting.
• Performs post-onboarding pre-bill review of professional charges and follow-up with new providers to confirm understanding of procedure, modifier and diagnosis code assignment, as well as, documentation requirements to promote billing compliance. Supporting two or more service lines, with supervision by Sr. Professional Billing Integrity Educator or Supervisor.
• Conducts increasingly independent reviews on adequacy of medical record documentation, to support the procedure, modifier and diagnosis coding of evaluation and management (E&M) services and low-moderate complexity diagnostic/therapeutic services, billed by physicians, practitioners or billing staff, in two or more service areas.
• Working with Sr. Professional Billing Integrity Educator or Supervisor, develops reports that summarize outcomes.
• Provides input on recommended corrective action plans.
• Research coding, documentation and reimbursement policy questions or problems submitted by physicians, practitioners, supported-departments, billing staff and others, to ensure compliance with specific payer and/or government regulations.
• Assist Senior Billing Integrity Educator and/or supervisor with responses.
• Escalates issues beyond their scope to Senior Billing Integrity Educator, Supervisor or Manager.
• In coordination with the Compliance Office, support and/or conduct Billing Compliance risk-based audits.
• Complete charge review and follow-up EPIC work queue assignments, within department timeliness standards, under guidance of the Senior Billing Integrity Educator or supervisor.
• Assists with quality assurance reviews for internal or contractor staff to verify the coding or other work is consistent and supported by regulations, University guidelines and/or MSRDP Medicine Audit Plan.
• Assists with training for contractor staff on the use of audit software, EPIC, internal audit plan, work queue assignments, etc. as needed.
• 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: High school or GED
• Number of Employees: 5,001-10,000 employees