Medical Coding Auditor

Medical Coding AuditorResponsible for auditing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to provide education on medical coding and documentation based on audit findings and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding accuracy and assure regulatory requirements are met.Texas Tech Health El Paso (TTEP) is not considering applications from individuals who require sponsorship for an employment visa, including those with H1B visas or those currently on student or postgraduate visas.Major/Essential FunctionsConduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance.Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines.Identify and address coding discrepancies and recommend corrective actions.Prepare detailed audit reports with findings and provide feedback on documentation and coding practices.Collaborate with relevant departments to resolve audit findings and ensure ongoing compliance with policies and regulations.Stay current with changes in coding guidelines, healthcare regulations, and payer policies.Assist in developing and refining audit tools, policies, and procedures to support continuous improvement.Monitor and track corrective actions post-audit, ensuring follow-up to resolve identified issues.Ensure abstracted data impacting reimbursement for all clinical locations is accurate: discharge disposition, indicators, procedure dates of service, etc.Adhere to physician and facility coding guidelines and coding policy and procedures, as needed.Lead coding/charge posting team communications/huddles, projects, and communicate Key Performance Indicator (KPI) requirements as determined by the Medical Coding Auditor Manager.Participate in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).Collaborate with appropriate teams to ensure claims data is transferred through the clearinghouse appropriately.Maintain professional relationships and collaborate across teams, managing projects, facilitating meetings, and presenting in various settings, including senior leadership.Remains current with all licensure, certifications and mandatory compliances and trainings required of this position.Adhere to all policies, procedures and practices (Regents Rules, TTUS, HSCEP OPs, etc.).Personally demonstrate, display and act in accordance with TTUHSC EP's Values (Service, Respect, Accountability, Integrity, Advancement, and Teamwork). Serve as a Value's leader while actively promoting and encouraging staff across the institution.Perform all other duties as assigned.Required QualificationsBachelor's degree in business, public administration or related field with one year of related experience.Combination of education and/or related experience to equal 5 years.Minimum 2 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).Preferred Qualifications5 years of relevant experience audit experience in physician or facility medical coding, auditing, or compliance roles.Prior experience reviewing medical records to ensure accurate coding and compliance with regulatory requirements in an academic medical or health sciences center.EEO StatementAll qualified applicants will be considered for employment without regard to sex, race, color, national origin, religion, age, disability, protected veteran status, or genetic information.Jeanne Clery ActThe Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. You can locate this report through our website at: StatementCompensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as, the institutional pay plan. For additional information, please reference the institutional pay plan on the Human Resources webpage.