Medical Coding Auditor chez TTUHSC El Paso

Responsible 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.

• Conduct 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

• Bachelor’s degree preferred
• 5 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

• Bachelor's degree in business, public administration or related field with one year of related experience
• Additional job-related education may be substituted for the required experience on a year-for-year basis
• 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)