Coding/Compliance Denials Analyst

Overview Coding/Compliance Denials Analyst - (937168) WHY UT SOUTHWESTERN? UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our benefits package includes healthcare, PTO and paid holidays, on-site childcare, wage and merit increases, and more. Join UT Southwestern to be part of a culture of teamwork, professionalism, and a rewarding career. JOB SUMMARY Develops outpatient coding education. Researches 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 official coding guidelines as supported by clinical documentation in health records and payer guidelines. Benefits UT Southwestern offers a competitive and comprehensive benefits package to eligible employees designed to support overall wellbeing. Benefits include: PPO medical plan, available day one at no cost for full-time employee-only coverage 100% 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 Learn more about these and other UT Southwestern employee benefits Experience and Education Required Experience : 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 Licenses and Certifications (CPC) Certified Professional Coder Upon Hire or (CPMA) Certified Professional Medical Auditor Upon Hire or (CEMC) Certified E/M Coder Upon Hire or (CPC-I) AAPC Approved Instructor Certification Upon Hire Preferred Education : Bachelor’s Degree in relevant field preferred or combination of education and experience Job Duties Develops outpatient coding education via spreadsheet. Researches 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 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. Communicates opportunities for documentation improvement related to coding issues (verbally and in written reports or summaries). 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 for outpatient coding. Reviews AHA and CPT quarterly coding update publications. Attends internal conference calls for Quarterly Coding Updates. Performs other duties as assigned. Security and EEO Statement Security : This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. EEO : UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. UT Southwestern policy also prohibits discrimination based on sexual orientation, gender identity, or gender expression. UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. In accordance with federal and state law, the University prohibits unlawful discrimination, including harassment, on the basis of race, color, religion, national origin, gender, including sexual harassment, age, disability, citizenship, and veteran status. Copyright 2017. The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390. Phone View phone number on click.appcast.io #J-18808-Ljbffr