• Reviews the coding of the physicians and coding personnel for accuracy and determines that the medical record is properly documented and contains faculty signature when appropriate.
• Assesses hospital and physician documentation for compliance with all regulations of federal and state agencies and third party payers, including Teaching Physician guidelines.
• Reviews the UB-92 or HCFA claim forms to ensure that proper codes appear on the forms which represent the services provided. Verifies accuracy of documentation to coding on the claim form.
• Produces billing reports of physicians and analyzes data to determine billing patterns of physicians. Provides analysis to supervisor.
• Monitors compliance with documentation standards; investigates, evaluates, and identifies opportunities for improvement. Provides guidance and counsel to departments regarding internal compliance controls.
• Analyzes and reviews denial codes from all payers to determine reasons for denial and correction of processes to reduce or eliminate denials for specific reasons. 
• Provides feedback to department administration and individual faculty regarding results of all reviews and analyses.
• Adheres to internal controls and reporting structure.

MARGINAL OR PERIODIC JOB FUNCTIONS:

• Performs related duties as required.

Standard office and audiovisual equipment. 

Working Environment:

Standard office and patient care environment.  May be required to work varying hours to accommodate feedback to physicians or other special projects. 

Other: 

Specific job requirements or physical location of some positions allocated to this classification, may render this position security sensitive, and thereby subject to the provisions of Section 51.215, Texas Education Code. 

Any qualifications to be considered as equivalents in lieu of stated minimums require the prior approval of the Chief Human Resources Officer.