HIM Physician Auditor - Full Time

<div class="content-intro"><p>Vail Health has become the world’s most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital.&nbsp; 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 Vail Health <a href="https://www.vailhealth.org/about">here</a>.</p></div><div>Some roles may be based outside of our Colorado office (remote-only positions). Roles based outside of our primary office can sit in any of the following states: AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, and WI. Please only apply if you are able to live and work primarily in one of the states listed above. State locations and specifics are subject to change as our hiring requirements shift.</div> <div>&nbsp;</div> <div><strong>About the opportunity:</strong></div> <div> <p>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.&nbsp;</p> </div> <div><strong>What you will do:</strong></div> <ul> <li>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.</li> <li>Review medical records to validate billed services, medical necessity, and identify discrepancies, errors, or potential fraud.</li> <li>Prepare detailed audit reports with findings, recommendations, and corrective action plans.&nbsp;&nbsp;</li> <li>Provide education and feedback to physicians, clinical staff, and team members on documentation improvement, coding accuracy, and compliance best practices.</li> <li>Collaborate with coding, compliance, and clinical teams to resolve audit findings and support cross-functional projects.&nbsp;&nbsp;</li> <li>Utilize audit results to deliver data-driven insights to providers and management for performance improvement and retraining.</li> <li>Stay current with coding standards, payer policies, and healthcare regulations; maintain professional knowledge through workshops and publications.</li> <li>Participate in internal and external audits, including regulatory inspections.</li> </ul> <div><strong>This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.</strong></div> <div>&nbsp;</div> <div><strong>What you will need:</strong></div> <div>&nbsp;</div> <div><strong>Experience:</strong></div> <ul> <li>5 years of experience in physician coding required</li> <li>5 years auditing and/or clinical documentation improvement, Pro Fee setting required</li> </ul> <div><strong>License(s) &amp; </strong><strong>Certification(s):</strong></div> <p>One of the following certifications required:</p> <ul> <li>Registered Health Information Technician (RHIT)</li> <li>Certified Coding Specialist (CCS/CCS-P)</li> <li>Certified Professional Coder (CPC)</li> <li>Certified Professional Medical Auditor (CPMA)</li> </ul> <div>&nbsp;</div> <div><strong>Education:</strong></div> <ul> <li>N/A</li> </ul> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Benefits at Vail Health (Full and Part Time) Include:</strong></p> <ul> <li><strong>Competitive Wages &amp; Family Benefits:</strong> <ul> <li>Competitive wages</li> <li>Parental leave (4 weeks paid)</li> <li>Housing programs</li> <li>Childcare reimbursement&nbsp;</li> </ul> </li> <li><strong>Comprehensive Health Benefits:&nbsp;</strong> <ul> <li>Medical</li> <li>Dental&nbsp;</li> <li>Vision</li> </ul> </li> <li><strong>Educational Programs:&nbsp;</strong> <ul> <li>Tuition Assistance&nbsp;</li> <li>Existing Student Loan Repayment</li> <li>Specialty Certification Reimbursement</li> <li>Annual Supplemental Educational Funds</li> </ul> </li> <li><strong>Paid Time Off:</strong> <ul> <li>Up to five weeks in your first year of employment and continues to grow each year.</li> </ul> </li> <li><strong>Retirement &amp; Supplemental Insurance:</strong> <ul> <li>403(b) Retirement plan with immediate matching&nbsp;</li> <li>Life insurance</li> <li>Short and long-term disability</li> </ul> </li> <li><strong>Recreation Benefits, Wellness &amp; More:</strong> <ul> <li>Up to $1,000 annual wellbeing reimbursement</li> <li>Recreation discounts</li> <li>Pet insurance</li> </ul> </li> </ul><div class="content-pay-transparency"><div class="pay-input"><div class="description"><p><em><span data-olk-copy-source="MessageBody">The posted salary range for this position is the anticipated hiring range in Colorado and will be adjusted based on geographic location. Vail Health considers a variety of factors in making compensation decisions which influence the offer a candidate receives.</span></em></p></div><div class="title">Hourly Pay:</div><div class="pay-range"><span>$32.43</span><span class="divider">&mdash;</span><span>$44.75 USD</span></div></div></div>