Full description
Company has become the world’s most advanced mountain healthcare system. Company consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail. Learn more about Company here.
About the opportunity:
The Physician Auditor is responsible for conducting detailed audits of physician documentation, coding, and billing practices to ensure compliance with regulatory standards, payer guidelines, and organizational policies. This role plays a critical part in maintaining the integrity of clinical documentation and revenue cycle processes, identifying areas for improvement, and supporting education initiatives for providers.
What you will do:
- Audit physician documentation and coding for multi-specialty providers to ensure accuracy, completeness, and compliance with ICD-10-CM, CPT, HCPCS, E/M leveling, payer guidelines, and regulatory standards.
- Review medical records to validate billed services, medical necessity, and identify discrepancies, errors, or potential fraud.
- Prepare detailed audit reports with findings, recommendations, and corrective action plans.
- Provide education and feedback to physicians, clinical staff, and team members on documentation improvement, coding accuracy, and compliance best practices.
- Collaborate with coding, compliance, and clinical teams to resolve audit findings and support cross-functional projects.
- Utilize audit results to deliver data-driven insights to providers and management for performance improvement and retraining.
- Stay current with coding standards, payer policies, and healthcare regulations; maintain professional knowledge through workshops and publications.
- Participate in internal and external audits, including regulatory inspections.
What you will need:
Experience:
- 5 years of experience in physician coding required
- 5 years auditing and/or clinical documentation improvement, Pro Fee setting required
License(s) & Certification(s):
One of the following certifications required:
- Registered Health Information Technician (RHIT)
- Certified Coding Specialist (CCS/CCS-P)
- Certified Professional Coder (CPC)
- Certified Professional Medical Auditor (CPMA)
Education:
- N/A
Benefits at Company (Full and Part Time) Include:
- Competitive Wages & Family Benefits:
- Competitive wages
- Parental leave (4 weeks paid)
- Housing programs
- Childcare reimbursement
- Comprehensive Health Benefits:
- Medical
- Dental
- Vision
- Educational Programs:
- Tuition Assistance
- Existing Student Loan Repayment
- Specialty Certification Reimbursement
- Annual Supplemental Educational Funds
- Paid Time Off:
- Up to five weeks in your first year of employment and continues to grow each year.
- Retirement & Supplemental Insurance:
- 403(b) Retirement plan with immediate matching
- Life insurance
- Short and long-term disability
- Recreation Benefits, Wellness & More:
- Up to $1,000 annual wellbeing reimbursement
- Recreation discounts
- Pet insurance
The posted salary range for this position is the anticipated hiring range in Colorado and will be adjusted based on geographic location. Company considers a variety of factors in making compensation decisions which influence the offer a candidate receives.
Originally posted on Himalayas