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 motivated Surgical Coding Auditor to join our
The Auditor will provide formal and
informal coding and regulatory education to all CU Medicine coding/charge
capture staff, billing staff, all attending physicians, residents and APP
providers involved with the billing for professional services as directed by
Federal and State requirements as well as the AMA. The individual in this position will also conduct
internal audits to ensure anyone involved in the billing for professional
services is in accordance with Federal and State regulations and payor policies
and procedures. This position will
support our surgical specialties.
Responsibilities of the Auditor include but are not limited to:
Perform detailed coder audits on a
regular basis as defined by compliance requirements, determine if additional
education is necessary and notify Training and Development of ongoing education
Work closely with the Education Program
Manager to create, revise and update all online/web/PowerPoint education
modules and materials as it relates to the coding and regulatory guidelines under
the direction of Audit, Compliance & Education leadership.
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 standards.
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.
Evaluate the appropriateness of the EHR
functionality being used, completing second level reviews on high complexity
Conduct educational documentation and coding training
for clinicians, and residents to support compliance with third party documentation and billing standards.
Prepare formalized reports from audit software of audit
results and present the results to ACE leadership, clinical chairs, and physicians.
Respond independently to questions from physicians
and School of Medicine (SOM) department administrative staff regarding billing,
coding and documentation.
programs for providers based on audit findings along with general education on
coding and documentation rules and regulations.
Perform follow-up reviews after initial
training of physicians and determine if additional education is necessary.
Provide any additional training once
identified by follow-up review.
Communicate regularly with internal
departments to ensure all necessary information is received on a timely basis.
Communicate and problem solve with
Managers and Supervisors on specific coding issues and/or training requests.
Work on joint projects with other
internal audit staff and internal CU Medicine departments to resolve billing
and documentation issues.
Perform any and all other assigned
Requires a bachelor’s degree in healthcare administration
(or related field) or equivalent/relevant
work experience. The ideal
candidate will have 3yrs of auditing 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
advanced 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
ability to train/teach adults is essential to success. 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 #321. 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