Medical Coding Auditor (Pathology)

Cumedicine; Aurora (CO); Remote; USD 60,000 - 80,000; Full time

Job summary

CU Medicine seeks a Medical Coding Auditor (Pathology) to join their Audit, Compliance & Education team. This role involves providing education and conducting internal audits to ensure compliance with coding regulations. The position offers a remote work opportunity and is aimed at enhancing the skills of the coding staff. Candidates should possess relevant experience and certifications in medical coding.

Benefits

Coding education during work hours

FREE CEUs towards CPC renewal

Remote work opportunity available

Qualifications

• 3 years of auditing experience in Pathology.
• Demonstrated knowledge of Medical Terminology and Anatomy & Physiology.
• Ability to train/teach adults.

Responsibilities

• Conduct internal audits and provide coding education.
• Create and update educational materials related to coding guidelines.
• Prepare reports of audit results for leadership.

Skills

Communication

Medical Terminology

Anatomy & Physiology

Third-party payer reimbursement

Education

Bachelor’s degree in healthcare administration or related field

CCS-P, CPC, or RHIA/RHIT certification

CPMA certification preferred

Tools

Microsoft Word

Excel

PowerPoint

Job description

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University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado.

We are seeking a motivated Medical Coding Auditor (Pathology) to join our Audit, Compliance & Education team.

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.

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 needs.
• 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 services.
• 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.
• Develop educational 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 responsibilities.
  

One of the many reasons CU Medicine is a great place to work:

• We offer coding education during regular work hours with FREE CEUs towards CPC renewal!
• 100% remote work opportunity...we will consider out of state candidates!
• CU Medicine has been successful in developing Auditors from experienced Medical Coders.
  
  

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, specifically within Pathology. 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. 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. The 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 and reference job#880.

All applications MUST be submitted via our website. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

CU Medicine is an Equal Opportunity Employer and complies with all applicable federal, state, and local laws governing non-discrimination in employment. We are committed to creating a workplace where all individuals are treated with respect and dignity, and we encourage individuals from all backgrounds to apply, including protected veterans and individuals with disabilities.

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.

The listed pay range (or hiring rate) represents CU Medicine’s good faith and reasonable estimate of the range of possible compensation at the time of posting and is based on evaluation of competitive market data.

A variety of factors, including but not limited to, internal equity, experience, and education will be considered when determining the final offer.

CU Medicine provides generous leave, health plans and retirement contributions which take your total compensation beyond the number on your paycheck. Find information about our benefits here.

CU Medicine will post all jobs for a minimum of 7 days or until 250+ applicants have been received (whichever comes first).

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 locations.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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