UT Health Compliance Coding Analyst in Healthcare Billing Compliance in Texas Medical Center-Houston, Texas
Compliance Coding Analyst in Healthcare Billing Compliance
Texas Medical Center-Houston, Texas
McGovern Medical School at UTHealth
Requisition #: 210002US
Coordinates, schedules, and performs coding and documentation reviews of medical/patient records to ensure proper billing practices are compliant with applicable laws, rules, and regulations. Provides departmental oversight and specialty-specific education related to physician coding/compliance, non-physician practitioner coding/compliance and appropriate coding conventions for individual staff members and collective groups within the department.
Position Key Accountabilities:
Performs physician billing reviews to establish compliance with teaching physician billing guidelines.
Acts as first-line liaison on behalf of Billing Compliance Coordination Department, as directed.
Preforms billing compliance audits via the MD Audit system, to include routine audits, special audits, risk based audits and special investigation audits for assigned department(s).
Coordinates education for all internal parties involved in the billing process.
Identifies provider specific educational needs relative to professional coding and documentation.
Acts as a resource and responds to billing and coding questions from providers, staff and administrators.
Assists in developing department billing compliance policies and procedures, to include the department’s Annual Compliance Plan, Bylaws and Risk Assessment.
Analyzes routine data/reports and denials from the billing process activities to identify trends, issues, and risk areas.
Ensures compliance with regulatory agencies, correct coding initiatives and regulatory guidelines for clinical documentation.
Performs other duties as assigned.
Effective analytical and communication skills; and extensive PC knowledge, especially in the area of word processing and spreadsheets.
One or more of the following certifications:
-Certified Professional Coder (CPC), or
-Certified Coding Specialist Physician-based (CCS-P), or
-Registered Health Information Administrator (RHIA), or
-Registered Health Information Technician (RHIT)
Bachelor’s degree in business, health administration, health information management or relevant work experience in lieu of education.
Three years direct experience or comparable competency in chart abstraction, ICD or CPT coding, charge documentation and charge capture resolution. Experience in academic health care auditing preferred.
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215
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University of Texas Health Science Center at Houston (UTHealth)
Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing and public health and the John P. and Kathrine G. McGovern Medical School. UTHealth includes The University of Texas Harris County Psychiatric Center, as well as the growing clinical practices UT Physicians, UT Dentists and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital.
UTHealth offers a comprehensive and competitive benefits package. For more information on our benefits programs please refer to the UTHealth Office of Benefits Website.
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