Texas Licensed Coding Quality Analyst

Job Summary

To support the Coding Department, the full-time hybrid Sr. Coding Quality Analyst will perform comprehensive reviews and investigations involving coding, documentation, billing, and operational processes while collaborating with various stakeholders to resolve identified issues.

Key responsibilities

• Conducts complex reviews and investigations into coding and billing concerns, establishing appropriate methodologies based on reported issues
• Collaborates with cross-functional teams to validate findings, document concerns, and recommend corrective actions
• Tracks and follows up on corrective actions to ensure effective resolution of identified issues and communicates outcomes to stakeholders

Required qualifications

• High school diploma required; a four-year degree in a related field is preferred
• Minimum of seven years of relevant experience in professional fee coding and billing compliance
• At least three years of experience in professional fee coding audits or complex coding reviews
• Current professional coding certification and auditing credential required
• Strong knowledge of coding guidelines, payer policies, and reimbursement requirements