Revenue Integrity Auditor & Educator II

%3Cp%3E%3Cstrong%3EWHY UT SOUTHWESTERN?%3C/strong%3E%3Cbr%3EWith 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 %3Ca href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22 target=%22_blank%22%3EU.S. News %26amp; World Report%3C/a%3E, 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%27ll discover a culture of teamwork, professionalism, and a rewarding career!%26nbsp;%3Cbr%3E%3Cbr%3E%3Cstrong%3EJOB SUMMARY%3C/strong%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EShift: Monday through Friday, 8am-5pm. Additional details shall be discussed as part of the interview process.%26nbsp;%3C/span%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cp%3E%3Cspan style=%22mso-fareast-font-family:%26quot;Times New Roman%26quot;;%22%3EWork From Home (WFH): This is a WFH opportunity. Candidates must live in Texas. Additional details shall be discussed as part of the interview process.%26nbsp;%26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%26nbsp;%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp%3EThe Revenue Integrity Educator II AKA Revenue Integrity Auditor %26amp; Educator 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:%26nbsp;%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3ERevenue Cycle Management Support:%3C/strong%3E Research coding, documentation and reimbursement inquiries submitted by physicians, clinical departments, or revenue cycle management to ensure compliance with specific payer and/or government regulations and optimum reimbursement. Prepares timely responses based on research outcome. Conduct quality assurance reviews to ensure coding and billing practices are accurate, compliant with regulations, and aligned with university policies and Revenue Cycle Management guidelines.%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3ENew Provider Education:%3C/strong%3E%26nbsp;Conduct standardized education for new providers (physicians, advanced practice providers, and other professional practitioners) for Internal Medicine, Pediatrics, Emergency Medicine, Radiology, PM%26amp;, R, Neurology, Psychiatry. Perform pre-bill reviews of professional charges and follow up with new providers to ensure accurate coding and documentation practices. Performs post-onboarding pre-bill review of professional charges and follow-up with new providers to confirm understanding documentation requirements to promote billing compliance.%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EClinical Department Education:%3C/strong%3E%26nbsp;Develop and conduct individual or group physician education presentations on coding, billing compliance guidelines, audit findings or internal reporting. Develop comprehensive content for presentations, including key concepts, regulations, case studies and practical examples.%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EBilling Compliance Reviews%3C/strong%3E: 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.%26nbsp;%26nbsp;%3C/p%3E%3Cp%3E%3Cstrong%3EBENEFITS%3C/strong%3E%3Cbr%3EUT 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:%3C/p%3E%3Cul%3E%3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%3Cli%3EPaid Time Off, available day one%3C/li%3E%3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%3Cli%3EPaid Parental Leave Benefit%3C/li%3E%3Cli%3EWellness programs%3C/li%3E%3Cli%3ETuition Reimbursement%3C/li%3E%3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%3Cli%3E%3Ca href=%22http://jobs.utsouthwestern.edu/benefits/#top%22 target=%22_blank%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cbr%3E%3Cstrong%3EEXPERIENCE AND EDUCATION%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ERequired%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EHigh School Diploma or equivalent.%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E5 years experience in a professional billing environment with emphasis on coding, auditing and compliance responsibilities%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3ELicenses and Certifications%3C/strong%3E%3Cbr%3E(CPC) CERT PROFESSIONAL CODER Upon Hire or%26nbsp;%3Cbr%3E(CCS) CERT CODING SPECIALIST Upon Hire or%26nbsp;%3Cbr%3E(CMC) CERT MEDICAL CODER Upon Hire%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EPreferred%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EAssociate%27s Degree or two years of college.%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cul%3E%3Cli%3E%3Cstrong%3ELicenses and Certifications%3C/strong%3E%3Cbr%3E(CPMA) Cert Prof Medical Auditor Upon Hire%26nbsp;%3Cbr%3E%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EJOB DUTIES%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EServes 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.%3C/li%3E%3Cli%3EConducts standardized new provider coding and compliance training (%22onboarding%22) 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.%3C/li%3E%3Cli%3EPerforms 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.%3C/li%3E%3Cli%3EConducts increasingly independent reviews on adequacy of medical record documentation, to support the procedure, modifier and diagnosis coding of evaluation and management (E%26amp;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.%3C/li%3E%3Cli%3EResearch 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.%3C/li%3E%3Cli%3EIn coordination with the Compliance Office, support and/or conduct Billing Compliance risk-based audits.%3C/li%3E%3Cli%3EComplete 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.%3C/li%3E%3Cli%3EAssists with training for contractor staff on the use of audit software, EPIC, internal audit plan, work queue assignments, etc. as needed.%3C/li%3E%3Cli%3EPerforms other duties, as assigned.%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3ESECURITY AND EEO STATEMENT%3C/strong%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ESecurity%3C/strong%3E%3Cbr%3EThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.%3Cbr%3E%3Cbr%3E%3Cstrong%3EEEO%3C/strong%3E%3Cbr%3EUT 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.%3Cbr%3E%26nbsp;%3C/p%3E

Job Details
Primary Location: Texas-Dallas-5323 Harry Hines Blvd
Work Locations: 5323 Harry Hines Blvd, Dallas, 75390
Job: Insurance/Billing
Organization: 713002 - MG Rev Cyc Front End
Schedule: Full-time
Shift: Day Job
Employee Status: Regular
Job Type: Standard
Job Level: Individual Contributor
Job Posting: Oct 8, 2026, 2:14:03 PM