Claims Solution Professional Auditor

Job Description:

Our employees whom we call “caregivers,” take pride in the contribution they make to lowering the cost of healthcare and improving the patient billing experience. Our caregivers work together to provide a collaborative, friendly environment and provide quality and individualized service.

Our Professional Claims Auditors leverage their professional coding expertise and knowledge of auditing regulations, protocols, and best practices as they audit and monitor the professional documentation and coding practices of physicians, APPs, clinical staff, and coding and billing personnel. They provide mentorship to Claims Solution Specialists and Claims Solution Specialist-Coders, and engage clinic leadership, providers, and other billing colleagues to participate in the continuous improvement efforts focused on increasing the efficiency and accuracy of the professional claims process.

Validates charges as entered by clinician or automated process.

Assists with new provider (physician and APP) coding setup and training and maintains ongoing auditing and feedback processes for providers and their staff.

Assists professional coding consultants and leadership in performing audits and providing analysis, interpretation, and report of claims denials and other payment issues contributing to poor operational performance.

Minimum Qualifications:     

• CPC Coding certification through AAPC or equivalent (e.g. CCS-P (Certified Coding Specialist - Physician) through AHIMA or DIP (certified Documentation Improvement Practitioner) thorugh AHIMA).

Professional coding experience or medical billing experience.

Preferred Qualifications:

CPMA auditor certification, or equivalent

Advanced coding knowledge (e.g., CCI edits, appeal management)

Training in continuous improvement theory and application

Physical Requirements

Interact with others requiring the employee to communicate information.

Operate computers and other office equipment requiring the ability to move fingers and hands.

See and read computer monitors and documents.

Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. 

Location:

Employee Service Center

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$27.65 - $43.55

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.