COMPLIANCE CODING AND BILLING ANALYST

Edtech.com's Summary

The University of Texas Rio Grande Valley is hiring a Compliance Coding and Billing Analyst. The role involves performing compliance reviews of billing and coding activities, conducting risk assessments, developing policies and training programs, and analyzing medical records and claims to ensure adherence to regulatory standards and institutional policies.

Highlights

Perform monitoring, compliance reviews, and risk assessments of medical billing and coding activities.
Develop policies, procedures, and risk-based educational training for compliance with federal/state laws and UTRGV policies.
Analyze medical records, claims, workflow processes, and coding to ensure accuracy and regulatory compliance.
Conduct investigations of non-compliant activities and recommend corrective and preventive measures.
Collaborate with medical billing teams to enhance clinical documentation quality.
Prepare billing compliance reports and present findings to senior management and committees.
Preferred certifications include CPMA, CPC, or CBCS from AHIMA or AAPC.
Requires a bachelor's degree in business, IT, health-related field, or equivalent education/experience with two years of related billing/coding or auditing experience.
Knowledge of CPT, DRG coding, medical billing terminology, and relevant healthcare laws and regulations is essential.
Bilingual skills (English/Spanish) and prior coding or auditing experience are preferred.

COMPLIANCE CODING AND BILLING ANALYST Full Description

Office Location
The University of Texas Rio Grande Valley
1201 W. University Drive
Human Resources
MASS Building 2nd Floor
Edinburg, TX 78539

Edinburg: (956)665-2451
Brownsville: (956) 882-8205

Office hours:
Monday-Friday
8:00a.m. - 5:00p.m.

Staff Recruitment: careers@utrgv.edu

School of Medicine Recruitment: SOMCareers@utrgv.edu

Graduate Assistantships: assistantships@utrgv.edu

Faculty Recruitment:
College of Engineering & Computer Science: cecs@utrgv.edu

Robert C. Vackar College of Business & Entrepreneurship: cobe@utrgv.edu

College of Sciences Office of the Dean: cos@utrgv.edu

College of Education and P-16 Integration: cep@utrgv.edu

College of Fine Arts: cofa@utrgv.edu

College of Liberal Arts: liberalarts@utrgv.edu

Website: https://careers.utrgv.edu

COMPLIANCE CODING AND BILLING ANALYST

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position, please click the Apply for this Job link/button.

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Please see Special Instructions for more details.

Dear Applicant,

Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following:

*Date of Birth
*Social Security Number
*Gender
*Ethnicity/Race

Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission.

If you have any questions, please do not hesitate to contact us at (956)665-8880 and/or careers@utrgv.edu.

Posting Details

Position Information

Posting Number	SRGV8902
Working Title	COMPLIANCE CODING AND BILLING ANALYST
Number of Vacancies	1
Location	McAllen, Texas
Department	Compliance
FTE	1.0
FLSA	Exempt
Scope of Job	Responsible for performing compliance reviews of billing and coding compliance functions and activities, compliance risk assessments, developing policies and procedures, and developing risk-based educational training to ensure compliance with federal/state laws and regulations and UTRGV policies. To review and analyze medical records, claims, and workflow processes to ensure accuracy, completeness, and compliance with regulatory requirements.
Description of Duties	Performs monitoring and compliance reviews of medical billing and coding compliance activities, associated risk assessments, developing policies and procedures and planning and developing risk-based educational training to ensure compliance with federal/state laws and regulations and UTRGV policies. Analyses and evaluates the effectiveness of compliance controls used by the area and its compliance with all applicable laws, policies, and procedures. Collects information and prepares billing compliance reports, provides supporting evidence, and conclusions, and makes recommendations for corrective measures on identified billing compliance. Analyzes data reports to identify issues and risk areas and makes recommendations as needed. Collaborates with the medical billing team to improve the quality of clinical documentation for compliance, billing, coding, and reimbursement processes. Reviews, assesses and analyzes medical records, coding, billing, claims, reimbursements and workflow processes to ensure accuracy, completeness, and compliance with regulatory requirements. Performs charge reviews comparing itemized bills to medical record documents to ensure appropriate charges. Performs reviews of electronic and manual documentation, coding, and billing systems. · Review, assess, study, and analyze the overall coding, billing, documentation, and reimbursement system for potential compliance problems. Conducts investigations of non-compliant, alleged breaches of policy to determine the cause and recommend a solution as well as preventative measures. Communicates findings to senior management and makes recommendations for preventive measures. Coordinates, evaluates and prepares quarterly reporting and verification through inspections and walk-throughs as assigned. Responsible for reviewing and preparing appropriate reports for the Physician’s Advisory Council, Executive Compliance Committee, and UT System as needed. Develops and maintains risk compliance-related education and training materials and conducts training sessions. Monitor emerging changes and trends in the law, regulations and industry standards relating to compliance with and enforcement of applicable law and report impactful developments. · Performs other duties as assigned.
Supervision Received	General supervision from assigned supervisor.
Supervision Given	Direct supervision of assigned staff.
Required Education	Bachelor’s degree in Business, IT or Health related field from an accredited university, or Associate’s degree in a related field with four (4) years of the required experience, or Education may be substituted with experience on a one-to-one basis.
Preferred Education	Bachelor’s degree in Health Information Management, Health care related field, Regulatory Compliance or Project Management or a related field from an accredited university.
Licenses/Certifications	Preferred: Certified Professional Medical Auditor (CPMA), Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) by the American Health Information Management Association (AHIMA) or the American Academy Professional Coders (AAPC).
Required Experience	Two (2) years of related billing/coding and or auditing experience. Education may be substituted with experience on a one-to-one basis
Preferred Experience	Coding, auditing or quality assurance review experience. Bilingual (English/Spanish)
Equipment	Use of standard office equipment.
Working Conditions	Needs to be able to successfully perform all required duties. Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Work is performed primarily in a general office environment. Some travel and weekend work is required. UTRGV is a distributed institution, which may require presence at multiple locations throughout the Rio Grande Valley.
Other	Strong verbal, written and interpersonal communication skills. Strong analytical skills. Ability to multi-task in a fast-paced environment. Detail oriented with excellent organizational skills and high degree of integrity and confidentiality. Ability to review, analyze, and interpret regulatory requirements in a clear and concise manner. Knowledge of state and federal laws applicable to healthcare and compliance industry. Knowledge of Current Procedural Terminology (CPT) and Diagnosis Related Group (DRG) coding. Knowledge of medical, billing and coding terminology and assignment of codes.
Physical Capabilities	N/A
Employment Category	Full-Time
Minimum Salary	Commensurate With Experience
Posted Salary	Commensurate with Experience
Position Available Date	04/06/2026
Grant Funded Position	No
If Yes, Provide Grant Expiration Date

Posting Detail Information

EEO Statement	It is the policy of The University of Texas Rio Grande Valley to promote and ensure equal employment opportunities for all individuals without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or protected veteran status. In accordance with the requirements of Title VII of the Civil Rights Act of 1964, the Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, as amended, our University is committed to comply with all government requirements and ensures non-discrimination in its education programs and activities, including employment. We encourage women, minorities and differently abled persons to apply for employment positions of interest.
Special Instructions to Applicants	Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: Date of Birth Social Security Number Gender Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please do not hesitate to contact us at (956)665-8880 and/or careers@utrgv.edu.
Additional Information	UTRGV is a distributed location institution and working location is subject to change based on need. All UTRGV employees are required to have a criminal background check (CBC). Incomplete applications will not be considered. Substitutions to the above requirements must have prior approval from the VP of HR & Talent Development .
Quick Link	https://careers.utrgv.edu/postings/50721

Posting Supplemental Questions

Required fields are indicated with an asterisk (*).

Are you now, or previously, employed by The University of Texas System or any of its institutions?
- Yes - I currently am employed by the UT System or its institutions
- Yes - I have previously been employed by the UT System or its institutions
- No - I have never been employed by the UT System or its institutions
Are you a current UTRGV employee?
- Yes
- No
Please select your highest level of completed education.
- 6th grade education
- 10th grade education
- High School Diploma or GED
- Associates Degree, Technical, or Trade School Degree/Certification or 60 Hours of College Hours
- Bachelors Degree from an accredited university
- Masters Degree from an accredited university
- Ph. D. or other terminal degree from an accredited university
- None of the above
Please provide the field of study for your education:
(Open Ended Question)
Do you meet the minimum requirements for this position?
- Yes
- No
Please indicate the number of years of work experience you have directly related to the position in which you are applying for:
- Less than 1 year
- 1 year
- 2 years
- 3 years
- 4 years
- 5 years
- 6 years
- 7 years
- 8 years
- 9 years
- 10 years
- Over 10 years

Applicant Documents

Required Documents

Resume

Optional Documents

Cover Letter/Letter of Application
Curriculum Vitae
Unofficial Transcripts
Reference Letter 1
Reference Letter 2
Reference Letter 3
Certifications and Licenses
Training Certificates
Other Document
List of 3 References
Unofficial Transcripts 2
Unofficial Transcripts 3
Letter of Interest
Unofficial Graduate Transcripts
Additional Document

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Original Job Description

Office Location
The University of Texas Rio Grande Valley
1201 W. University Drive
Human Resources
MASS Building 2nd Floor
Edinburg, TX 78539

Edinburg: (956)665-2451
Brownsville: (956) 882-8205

Office hours:
Monday-Friday
8:00a.m. - 5:00p.m.

Staff Recruitment: careers@utrgv.edu

School of Medicine Recruitment: SOMCareers@utrgv.edu

Graduate Assistantships: assistantships@utrgv.edu

Faculty Recruitment:
College of Engineering & Computer Science: cecs@utrgv.edu

Robert C. Vackar College of Business & Entrepreneurship: cobe@utrgv.edu

College of Sciences Office of the Dean: cos@utrgv.edu

College of Education and P-16 Integration: cep@utrgv.edu

College of Fine Arts: cofa@utrgv.edu

College of Liberal Arts: liberalarts@utrgv.edu

Website: https://careers.utrgv.edu

COMPLIANCE CODING AND BILLING ANALYST

If you would like to bookmark this position for later review, click on the Bookmark link. If you would like to print a copy of this position for your records, click on the Print Preview link.

Bookmark this Posting Print Preview | Apply for this Job

Please see Special Instructions for more details.

Posting Details

Position Information

Posting Number	SRGV8902
Working Title	COMPLIANCE CODING AND BILLING ANALYST
Number of Vacancies	1
Location	McAllen, Texas
Department	Compliance
FTE	1.0
FLSA	Exempt
Scope of Job	Responsible for performing compliance reviews of billing and coding compliance functions and activities, compliance risk assessments, developing policies and procedures, and developing risk-based educational training to ensure compliance with federal/state laws and regulations and UTRGV policies. To review and analyze medical records, claims, and workflow processes to ensure accuracy, completeness, and compliance with regulatory requirements.
Description of Duties	Performs monitoring and compliance reviews of medical billing and coding compliance activities, associated risk assessments, developing policies and procedures and planning and developing risk-based educational training to ensure compliance with federal/state laws and regulations and UTRGV policies. Analyses and evaluates the effectiveness of compliance controls used by the area and its compliance with all applicable laws, policies, and procedures. Collects information and prepares billing compliance reports, provides supporting evidence, and conclusions, and makes recommendations for corrective measures on identified billing compliance. Analyzes data reports to identify issues and risk areas and makes recommendations as needed. Collaborates with the medical billing team to improve the quality of clinical documentation for compliance, billing, coding, and reimbursement processes. Reviews, assesses and analyzes medical records, coding, billing, claims, reimbursements and workflow processes to ensure accuracy, completeness, and compliance with regulatory requirements. Performs charge reviews comparing itemized bills to medical record documents to ensure appropriate charges. Performs reviews of electronic and manual documentation, coding, and billing systems. · Review, assess, study, and analyze the overall coding, billing, documentation, and reimbursement system for potential compliance problems. Conducts investigations of non-compliant, alleged breaches of policy to determine the cause and recommend a solution as well as preventative measures. Communicates findings to senior management and makes recommendations for preventive measures. Coordinates, evaluates and prepares quarterly reporting and verification through inspections and walk-throughs as assigned. Responsible for reviewing and preparing appropriate reports for the Physician’s Advisory Council, Executive Compliance Committee, and UT System as needed. Develops and maintains risk compliance-related education and training materials and conducts training sessions. Monitor emerging changes and trends in the law, regulations and industry standards relating to compliance with and enforcement of applicable law and report impactful developments. · Performs other duties as assigned.
Supervision Received	General supervision from assigned supervisor.
Supervision Given	Direct supervision of assigned staff.
Required Education	Bachelor’s degree in Business, IT or Health related field from an accredited university, or Associate’s degree in a related field with four (4) years of the required experience, or Education may be substituted with experience on a one-to-one basis.
Preferred Education	Bachelor’s degree in Health Information Management, Health care related field, Regulatory Compliance or Project Management or a related field from an accredited university.
Licenses/Certifications	Preferred: Certified Professional Medical Auditor (CPMA), Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) by the American Health Information Management Association (AHIMA) or the American Academy Professional Coders (AAPC).
Required Experience	Two (2) years of related billing/coding and or auditing experience. Education may be substituted with experience on a one-to-one basis
Preferred Experience	Coding, auditing or quality assurance review experience. Bilingual (English/Spanish)
Equipment	Use of standard office equipment.
Working Conditions	Needs to be able to successfully perform all required duties. Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Work is performed primarily in a general office environment. Some travel and weekend work is required. UTRGV is a distributed institution, which may require presence at multiple locations throughout the Rio Grande Valley.
Other	Strong verbal, written and interpersonal communication skills. Strong analytical skills. Ability to multi-task in a fast-paced environment. Detail oriented with excellent organizational skills and high degree of integrity and confidentiality. Ability to review, analyze, and interpret regulatory requirements in a clear and concise manner. Knowledge of state and federal laws applicable to healthcare and compliance industry. Knowledge of Current Procedural Terminology (CPT) and Diagnosis Related Group (DRG) coding. Knowledge of medical, billing and coding terminology and assignment of codes.
Physical Capabilities	N/A
Employment Category	Full-Time
Minimum Salary	Commensurate With Experience
Posted Salary	Commensurate with Experience
Position Available Date	04/06/2026
Grant Funded Position	No
If Yes, Provide Grant Expiration Date

Posting Detail Information

EEO Statement	It is the policy of The University of Texas Rio Grande Valley to promote and ensure equal employment opportunities for all individuals without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or protected veteran status. In accordance with the requirements of Title VII of the Civil Rights Act of 1964, the Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, as amended, our University is committed to comply with all government requirements and ensures non-discrimination in its education programs and activities, including employment. We encourage women, minorities and differently abled persons to apply for employment positions of interest.
Special Instructions to Applicants	Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: Date of Birth Social Security Number Gender Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please do not hesitate to contact us at (956)665-8880 and/or careers@utrgv.edu.
Additional Information	UTRGV is a distributed location institution and working location is subject to change based on need. All UTRGV employees are required to have a criminal background check (CBC). Incomplete applications will not be considered. Substitutions to the above requirements must have prior approval from the VP of HR & Talent Development .
Quick Link	https://careers.utrgv.edu/postings/50721

Posting Supplemental Questions

Required fields are indicated with an asterisk (*).

Are you now, or previously, employed by The University of Texas System or any of its institutions?
- Yes - I currently am employed by the UT System or its institutions
- Yes - I have previously been employed by the UT System or its institutions
- No - I have never been employed by the UT System or its institutions
Are you a current UTRGV employee?
- Yes
- No
Please select your highest level of completed education.
- 6th grade education
- 10th grade education
- High School Diploma or GED
- Associates Degree, Technical, or Trade School Degree/Certification or 60 Hours of College Hours
- Bachelors Degree from an accredited university
- Masters Degree from an accredited university
- Ph. D. or other terminal degree from an accredited university
- None of the above
Please provide the field of study for your education:
(Open Ended Question)
Do you meet the minimum requirements for this position?
- Yes
- No
Please indicate the number of years of work experience you have directly related to the position in which you are applying for:
- Less than 1 year
- 1 year
- 2 years
- 3 years
- 4 years
- 5 years
- 6 years
- 7 years
- 8 years
- 9 years
- 10 years
- Over 10 years

Applicant Documents

Required Documents

Resume

Optional Documents

Cover Letter/Letter of Application
Curriculum Vitae
Unofficial Transcripts
Reference Letter 1
Reference Letter 2
Reference Letter 3
Certifications and Licenses
Training Certificates
Other Document
List of 3 References
Unofficial Transcripts 2
Unofficial Transcripts 3
Letter of Interest
Unofficial Graduate Transcripts
Additional Document

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COMPLIANCE CODING AND BILLING ANALYST

Edtech.com's Summary

COMPLIANCE CODING AND BILLING ANALYST Full Description

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