Revenue Integrity Educator II

University of Texas Southwestern Medical Center
parental leave, paid time off, paid holidays, tuition reimbursement, remote work
United States, Texas, Dallas
5323 Harry Hines Boulevard (Show on map)
Jan 24, 2025
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 This position works under minimal supervision to develop 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: Managing the New Provider Onboarding Process Managing New Provider Information: Monitoring start dates, schedules, and coordinating training needs with department support staff. Education Calendar Management: Scheduling sessions, maintaining the education calendar, and ensuring timely onboarding within 2-3 weeks of the provider's start date. Onboarding Materials Development: Creating and updating training materials, presentations, and guides to ensure accuracy and relevance. Monitor and evaluate the effectiveness of onboarding through ongoing assessments and feedback. Compliance and Quality Assurance: Ensuring all training materials meet regulatory standards and evaluating program effectiveness through assessments and feedback. Provider Education Session Management: Inviting providers to sessions and confirming attendance. Post-Education Follow-Up: Sending billing notifications, distributing materials, tracking attendance, and following up at 60 days for additional support. Feedback and Improvement: Monitoring feedback to enhance training sessions. Serve as a point of contact for new providers during and after onboarding to address questions and concerns. Hosting Education Sessions: Facilitate interactive and customized training tailored to provider specialties. Pre-Bill Charge Review and WQ Maintenance Pre-Bill Reviews: Conduct pre-bill reviews within 45 days of the provider's start date. Audit Coordination: Comparing Office of Internal Compliance (OIC) audit findings with Pre-bill review findings and sharing feedback to provider, revenue cycle management. Provider Feedback: Sharing pre-bill review summaries with providers and leadership. Billing: Notify the billing managers of issues related to charge capture or documentation noted during pre-bill review. Shift: Monday through Friday, 8am-5pm 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 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 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 CODER Upon Hire and (CCS) CERT CODING SPECIALIST Upon Hire and (CMC) CERT MEDICAL CODER Upon Hire and 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 integrity leader, under supervision of Sr. Professional Billing Integrity Educator or Supervisor, to develop and conduct individual or group presentations on coding, billing and compliance topics, based on new regulatory and professional coding industry information; pre-bill 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 Integrity 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-bill 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 Integrity 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 Integrity 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 Integrity Educator and/or supervisor with responses. Escalates issues beyond their scope to Senior Billing Integrity 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, within department timeliness standards, under guidance of the Senior Billing Integrity 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. 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 Statement 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. 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!