Quality Assurance Auditor

Job Summary

University Medical Billing (UMB) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too. We are looking for an experienced Quality Assurance Auditor to join our team. As the Quality Assurance Auditor, you will conduct audits of medical coding to increase coding accuracy and identify opportunities for improvement and training within an organization that provides healthcare patient services. Review audit results with medical coding management and staff. Provide training on coding guidelines, medical terminology, and proper documentation techniques. Serve as a resource for information on coding standards and regulatory requirements. Mid-level support role. Completes routine tasks under moderate supervision. Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB’s Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.

Responsibilities

• Reviews and audits professional coding and billing from multiple medical and surgical departments and entities of University Health Care.
• Reviews billing and revenue cycle processes for accuracy and process improvements.
• Provides education based on clinical documentation requirements related to regulatory and reimbursement rules and regulations, reimbursement systems (federal, state, and payer specific) and health insurance processing.
• Research coding, regulatory and billing policies, background, and instructions as needed to ensure high quality auditing, education, feedback, and subject matter expertise development.
• Has implicit understanding of the service line audited.
• Analyzes data to find billing irregularities and modify audit scope.
• Identifies inaccurate coding practices; prepares reports of findings and education on accurate coding practices, compliance risks, and revenue cycle efficiencies.
• Complete ad hoc related duties as assigned; meet performance standards and key performance expectations of position.

Minimum Qualifications

EQUIVALENCY STATEMENT: 1 year of higher education can be substituted for 1 year of directly related work experience (Example: bachelor’s degree = 4 years of directly related work experience). Medical Coding Quality Auditor (Healthcare), II: Requires at least 1 year of related experience. Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferred Qualifications

• Associate’s degree preferred
• CPC, AAPC Certification Required
• Minimum 6 years coding with progressive coding experience in multiple specialties
• Minimum 2 years auditing

Compensation & Benefits

The starting salary for this position is $36.00 to $39.00 per hour, depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University’s comprehensive benefit package that includes 90% employer-paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more!