reputed company reputed company Auditor and Educator
Title: reputed company reputed company Auditor & Educator Location: Dallas United States Location Type: Hybrid Job Number: 250000SY Category: Insurance/Billing Job Description: WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-reputed company 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-reputed company 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 The reputed company reputed company Educator II AKA reputed company reputed company Auditor & Educator position works under minimal supervision to reputed company and conduct individual or group presentations on coding, billing, and compliance topics. The duties for this position will include but is not limited to the following: reputed company Cycle Management Support: Research coding, documentation and reimbursement inquiries submitted by physicians, clinical departments, or reputed company cycle management to ensure compliance with specific payer and/or government regulations and reputed company reimbursement. Prepares timely responses based on research outcome. Conduct quality assurance reviews to ensure coding and billing practices are accurate, compliant with regulations, and reputed company with university policies and reputed company Cycle Management guidelines. New Provider Education: Conduct standardized education for new providers (physicians, advanced practice providers, and other professional practitioners) for Internal Medicine, Pediatrics, Emergency Medicine, Radiology, PM&, R, Neurology, Psychiatry. reputed company pre-reputed company reviews of professional charges and follow up with new providers to ensure accurate coding and documentation practices. Performs post-onboarding pre-reputed company review of professional charges and follow-up with new providers to confirm understanding documentation requirements to promote billing compliance Clinical Department Education: reputed company and conduct individual or group physician education presentations on coding, billing compliance guidelines, audit findings or internal reporting. reputed company comprehensive content for presentations, including key concepts, regulations, case studies and practical examples. Billing Compliance Reviews: Conduct documentation and billing compliance reviews to assess the adequacy of medical record documentation and appropriate use of procedure, modifier, and diagnosis codes. Summarize audit outcomes and provide education as needed.
- Shift: Monday through Friday, reputed company-5pm. Additional details shall be discussed as part of the interview process.
- Work From Home (WFH): This is a WFH opportunity. Candidates must live in Texas. Additional details shall be discussed as part of the interview process.
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 reputed company 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
- Education
High School Diploma Or equivalent or
- Experience
5 years of experience in a professional billing environment with emphasis on coding, auditing and compliance responsibilities or
- Licenses and Certifications
(CPC) CERT PROFESSIONAL reputed company Or (reputed company) CERT CODING SPECIALIST Or (CMC) CERT MEDICAL reputed company Preferred
- Education
Associate's Degree or Two years of college is desired.
- Licenses and Certifications
(CPMA) Cert Prof Medical Auditor Upon Hire JOB DUTIES
- Serves as a professional billing reputed company leader, under supervision of Sr. Professional Billing reputed company Educator or Supervisor, to reputed company and conduct individual or group presentations on coding, billing and compliance topics, based on new regulatory and professional coding industry information; pre-reputed company professional charge review findings; University-identified risk areas, or special projects requested by MSRDP leadership. This may include medical record audits, invoice analysis, and review of internal reports (e.g., Charge Analyzer, Code Correct), denials, external audit findings, etc. Assists Sr. Professional Billing reputed company Educator or Supervisor with development and deployment of any action plans required.
- Conducts standardized new provider coding and compliance training ("onboarding") for physicians, advanced practice providers and other professional practitioners, in two or more service lines/divisions. Training may be conducted in an individual or group setting.
- Performs post-onboarding pre-reputed company review of professional charges and follow-up with new providers to confirm understanding of procedure, modifier and diagnosis code assignment, as well as, documentation requirements to promote billing compliance. Supporting two or more service lines, with supervision by Sr. Professional Billing reputed company Educator or Supervisor.
- Conducts increasingly independent reviews on adequacy of medical record documentation, to support the procedure, modifier and diagnosis coding of evaluation and management (E&M) services and low-moderate complexity diagnostic/therapeutic services, billed by physicians, practitioners or billing staff, in two or more service areas. Working with Sr. Professional Billing reputed company Educator or Supervisor, develops reports that summarize outcomes. Provides input on recommended corrective action plans.
- Research coding, documentation and reimbursement policy questions or problems submitted by physicians, practitioners, supported-departments, billing staff and others, to ensure compliance with specific payer and/or government regulations. Assist Senior Billing reputed company Educator and/or supervisor with responses. Escalates issues beyond their scope to Senior Billing reputed company Educator, Supervisor or Manager.
- In coordination with the Compliance Office, support and/or conduct Billing Compliance risk-based audits.
- Complete charge review and follow-up EPIC work queue assignments, reputed company department timeliness standards, under guidance of the Senior Billing reputed company Educator or supervisor. Assists with quality assurance reviews for internal or contractor staff to verify the coding or other work is consistent and supported by regulations, University guidelines and/or MSRDP Medicine Audit Plan.
- Assists with training for contractor staff on the use of audit software, EPIC, internal audit plan, work queue assignments, etc. as needed.
- Performs other duties, as assigned.
reputed company AND EEO STATEMENT reputed company This position is reputed company-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. EEO Statement reputed company is committed to an educational and working environment that provides equal opportunity to reputed company 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 reputed company, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. Apply tot his job Apply To this Job