The University of Texas Medical Branch Auditor, Coding and QA - Revenue Cycle Coding - Shearn Moody Plaza in Galveston, Texas
High school diploma or equivalent and four years of medical billing or related experience, or related training from an accredited agency. Must meet minimum qualifications of a Sr. Coder and be proficient in auditing and reporting. At least one year analytical experience. CCA, CCS, or CCSP coding certification from AHIMA; or CPCA, CPC, CPCHA coding certification from AAPC.
To provide internal coding quality reviews to ensure compliance with official coding guidelines for hospital and physician coding. Review of billed charges from medical record documents to ensure that the documentation supports the billed services; to report any coding discrepancies; and to provide training to physicians and coders to eliminate any discrepancies. This position provides training and education to the Coding Staff and Medical Staff and maintains current department policies related to coding and charge posting. This position also assists with coding production, as needed, reviews and resolves coding issues related to billing, researches complex coding issues and participates in process improvement related to coding and E & M management. Codes professional and outpatient technical charges for multiple clinics to ensure accuracy and optimal reimbursement from all third party payers.
Specific Job Related Duties
ESSENTIAL JOB FUNCTIONS:
- Develops internal coding and documentation auditing programs to address both inpatient and professional coding issues.
- Performs internal coding and documentation quality reviews of coded inpatient and professional services to verify accuracy and specificity of assigned codes.
- Develops RCO coder education to address issues identified by monitoring based on audit results.
- Assists with analysis of data/reports monitoring activities to help identify trends, issues, risk areas, and opportunities for coder and provider education.
- Prepares and presents reports summarizing education activities.
- Keeps RCO Leadership informed of audit progress.
- Manages the education activities so time is used efficiently and departmental quality management standards are met.
- Maintains current knowledge regarding federal, state, and local coding and compliance guidance, initiatives, work plans, and payer regulations. Communicates and provides this information to coders in a timely manner.
- Ensures that coding education standards are updated appropriately to reflect regulatory changes.
- Educate and offer feedback to providers as needed to ensure that documentation is complete, accurate and compliant with guidelines.
- Performs related duties as required.
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or veteran status. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
Full/Part Time: Full-Time
Job Title: Auditor, Coding and QA - Revenue Cycle Coding - Shearn Moody Plaza
Job ID: 52801
Business Unit: FINCE