Texas Health Resources
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Manager Compliance Coding
role at
Texas Health Resources .
Location & Hours
Work location: Texas Health Resources.
Core work hours: Monday – Friday; 8:00a-5:00p.
Position Summary The Coding Compliance Manager oversees and manages auditing and monitoring activities related to billing and coding compliance. This role is responsible for developing policies, procedures, and risk‑based educational materials to ensure adherence to federal and state regulations, as well as THR policies. The Manager analyzes audit data to identify areas of concern, collaborates with auditees, providers, and leadership to guide rebuttals, and establishes management correction plans when necessary. The Compliance Auditor Manager effectively communicates audit findings through reports, presentations, and educational materials tailored for executive leadership and relevant stakeholders, providing guidance to providers, HIMS, the Central Billing Office, and other departments regarding coding compliance, documentation standards, and applicable regulations.
Key Responsibilities
Analyzes audit data to identify areas of concern.
Collaborates with auditees, providers, and leadership to guide rebuttals.
Establishes management correction plans when necessary.
Communicates audit findings through reports, presentations, and educational materials tailored for executive leadership and relevant stakeholders.
Provides guidance to providers, HIMS, the Central Billing Office, and other departments regarding coding compliance, documentation standards, and applicable regulations.
Conducts internal audit testing to ensure adherence to regulatory requirements and organizational policies.
Assists the audit team with inpatient, outpatient, and provider coding assessments to ensure proper documentation and adherence to policies.
Performs second‑level reviews of billing performance to verify compliance with legal policies and regulatory requirements.
Prepares detailed audit reports and presents findings to senior leadership, Texas Health management, and relevant committees.
Conducts follow‑up audits when findings indicate significant compliance risks, ensuring corrective actions are implemented.
Job Qualifications
Six years of experience conducting compliance coding and billing audits, including supervisory and leadership experience in a medium to large healthcare system.
Experience partnering with providers on coding, documentation improvement, and audit findings a plus.
Strong understanding of leadership principles and best practices in team management, direction, and development.
Expertise in planning, scheduling, and overseeing projects to drive operational efficiency.
Exceptional oral and written communication skills to effectively convey complex regulatory and compliance concepts.
Ability to analyze data, identify trends, and recommend solutions for complex compliance and coding challenges.
Extensive knowledge of MS DRG, APC, ICD‑10‑CM/PCS, CPT, HCPCS coding, modifiers, NCCI edits, and official coding guidelines.
Proficiency in Microsoft Office products (Excel, Word, PowerPoint).
Ability to provide clear and constructive feedback to coders, non‑coders, and senior leadership, translating complex coding rules into actionable insights.
Demonstrated ability to work autonomously, meet deadlines, and apply critical thinking skills in decision‑making.
Strong listening skills and ability to train others, lead meetings, and facilitate education sessions.
Expertise in ensuring documentation accurately captures a patient's health status and clinical condition.
Proficiency in researching Medicare, OIG, CMS, and other regulatory sources to interpret policies and industry standards.
Education Bachelor's Degree Required.
Licenses and Certifications
RHIT – Registered Health Information Technician (Upon Hire Required)
RHIA – Registered Health Information Administrator (Upon Hire Required)
CCS – Certified Coding Specialist (Upon Hire Required)
CPC – Certified Professional Coder (Upon Hire Required)
Skills
Strong leadership and team management skills.
Effective project planning, scheduling, and oversight.
Excellent oral and written communication.
Data analysis and trend identification.
Comprehensive coding expertise (MS DRG, APC, ICD‑10‑CM/PCS, CPT, HCPCS, NCCI, etc.).
Microsoft Office proficiency.
Constructive feedback and coaching abilities.
Documentation accuracy focus.
Regulatory research proficiency.
Why Texas Health? At Texas Health Resources, our mission is “to improve the health of the people in the communities we serve”. As part of a 28,000+ employee organization, we offer top‑notch career growth, professional development opportunities, and outstanding benefits. Join a dedicated team committed to improving community health every day.
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Manager Compliance Coding
role at
Texas Health Resources .
Location & Hours
Work location: Texas Health Resources.
Core work hours: Monday – Friday; 8:00a-5:00p.
Position Summary The Coding Compliance Manager oversees and manages auditing and monitoring activities related to billing and coding compliance. This role is responsible for developing policies, procedures, and risk‑based educational materials to ensure adherence to federal and state regulations, as well as THR policies. The Manager analyzes audit data to identify areas of concern, collaborates with auditees, providers, and leadership to guide rebuttals, and establishes management correction plans when necessary. The Compliance Auditor Manager effectively communicates audit findings through reports, presentations, and educational materials tailored for executive leadership and relevant stakeholders, providing guidance to providers, HIMS, the Central Billing Office, and other departments regarding coding compliance, documentation standards, and applicable regulations.
Key Responsibilities
Analyzes audit data to identify areas of concern.
Collaborates with auditees, providers, and leadership to guide rebuttals.
Establishes management correction plans when necessary.
Communicates audit findings through reports, presentations, and educational materials tailored for executive leadership and relevant stakeholders.
Provides guidance to providers, HIMS, the Central Billing Office, and other departments regarding coding compliance, documentation standards, and applicable regulations.
Conducts internal audit testing to ensure adherence to regulatory requirements and organizational policies.
Assists the audit team with inpatient, outpatient, and provider coding assessments to ensure proper documentation and adherence to policies.
Performs second‑level reviews of billing performance to verify compliance with legal policies and regulatory requirements.
Prepares detailed audit reports and presents findings to senior leadership, Texas Health management, and relevant committees.
Conducts follow‑up audits when findings indicate significant compliance risks, ensuring corrective actions are implemented.
Job Qualifications
Six years of experience conducting compliance coding and billing audits, including supervisory and leadership experience in a medium to large healthcare system.
Experience partnering with providers on coding, documentation improvement, and audit findings a plus.
Strong understanding of leadership principles and best practices in team management, direction, and development.
Expertise in planning, scheduling, and overseeing projects to drive operational efficiency.
Exceptional oral and written communication skills to effectively convey complex regulatory and compliance concepts.
Ability to analyze data, identify trends, and recommend solutions for complex compliance and coding challenges.
Extensive knowledge of MS DRG, APC, ICD‑10‑CM/PCS, CPT, HCPCS coding, modifiers, NCCI edits, and official coding guidelines.
Proficiency in Microsoft Office products (Excel, Word, PowerPoint).
Ability to provide clear and constructive feedback to coders, non‑coders, and senior leadership, translating complex coding rules into actionable insights.
Demonstrated ability to work autonomously, meet deadlines, and apply critical thinking skills in decision‑making.
Strong listening skills and ability to train others, lead meetings, and facilitate education sessions.
Expertise in ensuring documentation accurately captures a patient's health status and clinical condition.
Proficiency in researching Medicare, OIG, CMS, and other regulatory sources to interpret policies and industry standards.
Education Bachelor's Degree Required.
Licenses and Certifications
RHIT – Registered Health Information Technician (Upon Hire Required)
RHIA – Registered Health Information Administrator (Upon Hire Required)
CCS – Certified Coding Specialist (Upon Hire Required)
CPC – Certified Professional Coder (Upon Hire Required)
Skills
Strong leadership and team management skills.
Effective project planning, scheduling, and oversight.
Excellent oral and written communication.
Data analysis and trend identification.
Comprehensive coding expertise (MS DRG, APC, ICD‑10‑CM/PCS, CPT, HCPCS, NCCI, etc.).
Microsoft Office proficiency.
Constructive feedback and coaching abilities.
Documentation accuracy focus.
Regulatory research proficiency.
Why Texas Health? At Texas Health Resources, our mission is “to improve the health of the people in the communities we serve”. As part of a 28,000+ employee organization, we offer top‑notch career growth, professional development opportunities, and outstanding benefits. Join a dedicated team committed to improving community health every day.
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