Texas Licensed Coding Quality Analyst

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