Compliance Analyst III, Professional Billing

About the role

With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!

The Compliance Analyst III conducts complex professional billing and coding compliance audits and reviews, including evaluation of medical record documentation, coding, billing, modifiers, medical necessity, and other reimbursement requirements. Evaluate provider billing practices for compliance with applicable federal and state requirements, payer requirements, and institutional policies and procedures. Perform risk-based and targeted reviews involving higher-risk professional billing areas, including evaluation and management services, procedural services, teaching physician requirements, split/shared services, incident-to billing, modifiers, time-based services, and other specialty-specific billing requirements. Analyze claims, coding, reimbursement, and other data to identify trends, outliers, potential overpayments, and emerging