Remote Utilization Review Rn Jobs in Texas (NOW HIRING)

Now Hiring – Coding Educator & Auditor Revenue Integrity

University Health is one of the largest employers in San Antonio. We are a nationally recognized teaching hospital and consistently recognized as a leader in advanced treatment options, new technologies and clinical research. Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery. We are currently looking for a talented health professional to join our team as a Coding Educator & Auditor for our Revenue Integrity department. This is an exciting opportunity to join a company with a reputation for exceptional service and patient care.

The Position:

Works under the direct supervision of the Coding Education & Audit Manager. Will perform any or a combination of the following types of coding education and audit: Basic ancillary services, Emergency Room services, Hospital Observation, Ambulatory surgery, Inpatient Admission. Utilizes the ICD-10-CM and CPT coding classification systems and ensures proper assignment and completion of Diagnosis and Procedure Coding on all cases. Trains new Coding Specialist(s), Technician(s), and Associate(s). Promotes the Health System’s guest relations’ policy. Complies with all Federal, State, local and accrediting bodies’ regulations and protocols.  Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC), and the Joint Commission (TJC).

Duties:

• Communicates and interacts positively and professionally throughout all levels of the organization, and with external customers. Consistently demonstrates the ability to communicate with strong analytical, problem solving and critical thinking skills.
• Provides onsite and remote quality assurance reviews/audits with appropriate compliance with governmental and payer regulations.
• Provides and monitors instructions/education provided to Providers, Coding, Risk, CDI, and Quality team members involved with the coding processes.
• Implements Coding Education programs for professional and facility Service lines, including ongoing assessment, metrics and dashboards.
• Prepares departmental coding and denial progress reports. 
• Performs other related duties as assigned.

Qualifications:

Associate’s degree in Health Information Management and/or Bachelor’s degree is preferred. Completion of a coding program is required. [Note: Completion of a coding program from the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPCS) will be accepted.  Completion of a coding program from other licensing bodies shall be accepted on a case by case basis and upon managerial discretion, with the approval of the Director of Revenue Integrity-Coding.] At least five (5) years of coding experience in professional services, hospital services, or a combination of both is required for external applicants.  At least four (4) years of pro-fee, outpatient/ambulatory, and inpatient coding experience is required for internal applicants. Experience and working knowledge of 3M Encoding and Grouping software is required. Preference will be given to applicants with experience and knowledge of regulatory requirements, Microsoft Office products, and Epic EMR.

LICENSURE/CERTIFICATION:

The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies mentioned above (AHIMA and AAPC).  [Note: Valid credential(s) from the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPC) will be accepted.  Credential(s) from other licensing bodies shall be accepted on a case by case basis and upon managerial discretion, with the approval of the Director of Revenue Integrity-Coding]. Licensure as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), and/or Registered Nurse(s) (RN) are highly preferred.

Why Should You Apply?

• We offer exceptional pay and opportunities for advancement.
• Continuing Education
• Gym membership discounts
• Comprehensive benefits package including pet insurance

Apply today!  Don’t miss out on this great opportunity.