Coding/Compliance Denials Analyst

WHY UT SOUTHWESTERN?

With over 75 years of excellence in Dallas-Fort Worth, Texas, 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 highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!

JOB SUMMARY

Develops outpatient coding education. Research 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 the official coding guidelines as supported by clinical documentation in health record and payer guidelines.

BENEFITS

UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and 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 UTSW 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) CERT PROFESSIONAL CODER Upon Hire or

(CPMA) Cert Prof 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 equivalent of education and experience

JOB DUTIES

Develops outpatient coding education via spreadsheet.

Research 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 that will be 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. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.

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 (OPPS ICD-10-CM, and CPT updates) for outpatient coding. Reviews AHA and CPT quarterly coding update publications. Attends all 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, including 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.

Schedule: Full-time

Shift: Day Job

Travel: