CU Medicine is dedicated to
providing business operations and administrative support to the University of
Colorado School of Medicine’s nearly 3,000 providers and is affiliated with the
leading medical institutions in the West. Located adjacent to the Anschutz
Medical Campus, one of the largest and most advanced academic medical campuses
in the country, CU Medicine offers a variety of administrative, technical and
healthcare support career opportunities and serves as a resource for patients
We are seeking a highly skilled Senior Medical Coding &
Documentation Auditor to join our team.
The Senior Auditor is responsible for conducting
internal audits of the medical documentation, coding, and billing in a provider
setting in accordance with Federal and State regulations and payer policies and
procedures. These audits determine whether billed services provided to patients,
are consistent with medical record documentation and in accordance with the
appropriate third party billing regulations and/or standards. The individual in
this position will communicate findings to the Medical Staff and other
appropriate personnel, and will provide education on identified issues.
The Senior Auditor will provide
oversight, training, guidance and/or assistance to other auditing staff in the
daily routine tasks of their position, under the direction of the Audit,
Compliance & Education (ACE) Leadership.
The individual in this position will assist in assuring consistent
quality performance between and among the provider audit team. This position will be responsible for new
hire training and is expected to make recommendations to improve workflow,
process and productivity. In addition,
this position will conduct confidential internal/external compliance reviews,
communicate findings with ACE Leadership and perform follow up education as
include but are not limited to:
- Conduct internal audits of medical
documentation supporting claims billed to third parties to ensure billing
is done in accordance with the appropriate third party regulations and/or
- Evaluate the appropriateness of the services
and procedures billed based on the supporting documentation.
- Evaluate the appropriateness of diagnoses
billed for all services in accordance with coding guidelines.
- Evaluate propriety of the level of service
billed for evaluation and management services based on the supporting documentation.
- Conduct training and provide educational
sessions for clinicians, and residents to support compliance with third party documentation and billing standards and
to present new information including
yearly updates and changes in requirements.
- Provide follow-up reviews after
initial training of physicians and determine if additional education is
- Prepare written reports of the results of the
audits and present to management, clinical chairs, physicians, and
department billing staff.
- Respond to questions from physicians and School
of Medicine (SOM) department administrative staff regarding billing,
coding and documentation.
- Provide new hire Auditor training
and assist in ongoing training of auditing staff to ensure uniformity and
quality of work.
- Prepare and/or revise compliance
documentation and billing manuals for routine and special training
- Attend committee meetings as assigned by Department
- Participate and oversee joint projects with
other internal audit staff and internal CU Medicine departments to resolve
billing and documentation issues.
- Perform other duties and complete special projects
as assigned by Director.
Requires a bachelor’s degree in healthcare administration (or
related field) or 5 yrs.
relevant work experience. Must possess an active CCS-P or CPC or RHIA/RHIT
certification in conjunction with auditing credentials (i.e. CPMA). Demonstrated knowledge of Medical Terminology
and Anatomy & Physiology combined with high level expertise in third-party
payer reimbursement, coding, and documentation requirements are essential to
success. Knowledge of Medicare and
Medicaid regulations is required. Must
have experience in Evaluation and Management coding. Experience in a teaching/academic medical
environment is a plus. The ideal
candidate will demonstrate superior
communication skills including verbal, written and large audience presentations. High level proficiency in the
use of various computer systems including Microsoft Word, Excel, PowerPoint,
and other database software skills are required.
TO APPLY FOR THIS POSITION, please visit our website at www.cumedicine.us.
Reference job #320. All applications MUST be submitted via our website.
CU Medicine is dedicated to ensuring a safe and secure environment
for our staff and visitors. To assist in achieving that goal, we conduct
background investigations for all prospective employees prior to their
employment. We are an equal opportunity employer.
CU Medicine supports a Tobacco Free
Workplace Environment which prohibits smoking and the use of tobacco products
on CU Medicine property, Anschutz Medical Campus and adjacent business