Billing and Coding Specialist

Job Summary:

The Billing and Coding Specialist is responsible for ensuring accurate and compliant coding and billing practices for professional medical services within a family medicine clinical setting. This position will focus on clinician documentation evaluation, review, and recommendations via education to maximize coding/documentation with the goal of enhancing billables and collections. This role involves educating providers, residents, and staff on coding regulations, audit enhancement reviews, and providing expertise on coding guidelines, reimbursement requirements, and documentation standards. The Billing and Coding Specialist will operate within the Department of Family Medicine Clinical Affairs mission area and will work collaboratively with various service centers within CU Medicine to optimize billing/collection processes and ensure compliance with federal, state, and payer policies.

Key Responsibilities:

• Provide formal and informal coding and regulatory education to coding/charge capture staff, billing staff, clinicians, residents, and APPs.
• Conduct internal audits to ensure compliance with federal and state regulations, payer policies, and procedures.
• Evaluate the appropriateness of billed services, procedures, diagnoses, and levels of service based on supporting documentation.
• Assess the appropriateness of EHR functionality usage (charge capture and documentation) and conduct second-level reviews on complex services.
• Develop and conduct educational documentation and coding training for clinicians and residents.
• Prepare formalized reports and present results to Clinical Affairs leadership, medical directors, clinical program directors, and clinicians.
• Respond to inquiries from clinicians and administrative staff regarding billing, coding, and documentation.
• Develop educational programs for providers based on audit findings and general coding/documentation rules.

Work Location:

Hybrid - this role is eligible for a hybrid schedule with occasional travel to meet with theclinicians at each of our HOPD practices, attend Clinical Affairs Team meetings on a PRN basis, and attend the quarterly in-person medical director meetings.

Why Join Us:

An Exciting Opportunity: At the University of Colorado's Department of Family Medicine, we are committed to a mission of "To heal, teach, discover, and connect. Together." As a leader in primary care innovation, we strive to provide outstanding family medicine, create, and share new knowledge, train future healthcare professionals, and achieve health equity through community engagement and advocacy.

By joining us, you will be part of a dedicated team working to transform healthcare delivery and improve the lives of patients and communities. Our collaborative, supportive environment empowers staff to contribute to meaningful change and fosters professional growth. You'll have the opportunity to play a key role in advancing our strategic plan and creating lasting, positive impact within a diverse, mission-driven department. Together, we can shape the future of family medicine.

Why work for the University?

We have AMAZING benefits and offer exceptional amounts of holiday, vacation, and sick leave! The University of Colorado offers an excellent benefits package including:

• Medical: Multiple plan options
• Dental: Multiple plan options
• Additional Insurance: Disability, Life, Vision
• Retirement 401(a) Plan: Employer contributes 10% of your gross pay
• Paid Time Off: Accruals over the year
• Vacation Days: 22/year (maximum accrual 352 hours)
• Sick Days: 15/year (unlimited maximum accrual)
• Holiday Days: 10/year
• Tuition Benefit: Employees have access to this benefit on all CU campuses
• ECO Pass: Reduced rate RTD Bus and light rail service

There are many additional perks & programs with the CU Advantage.

Diversity and Equity:

The University of Colorado Anschutz Medical Campus is committed to recruiting and supporting a diverse student body, faculty, and administrative staff. The university strives to promote a culture of inclusiveness, respect, communication and understanding. We encourage applications from women, ethnically minoritized individuals, persons with disabilities, persons within the LGBTQ+ community and all veterans. In addition, the Anschutz Campus has also been recognized as an Age-Friendly University. The University of Colorado is committed to diversity and equality in education and employment.

Qualifications:

Minimum Qualifications:

• Bachelor's degree in healthcare administration or a related field.
  
  
  
  • A combination of education and related professional experience may be substituted for the bachelor's degree on a year-for-year basis.
  
  
  
  
• Three (3) years of clinical coding/auditing experience in a primary care or similar environment.
• Active CCS-P, CPC, or RHIA/RHIT certification in conjunction with auditing credentials (e.g., CPMA).
• Experience with commercial and government payers
• Experience with third-party payer reimbursement, coding, and documentation requirements.
• Experience with specific primary care medicine and/or sports medicine coding, ie CPT, HCC, ICD-10, HCPCS
• Experience with EHR systems.

Applicants must meet minimum qualifications at the time of hire.

Preferred Qualifications:

• Four (4) or more years of clinical coding/auditing experience in a primary care or similar environment.
• Experience in a teaching/academic medical environment.
• Multi-specialty auditing experience.
• Experience in professional fee and/or facility fee setting.
• Experience with outpatient (HOPD, freestanding) and inpatient coding, risk adjustment auditing.
• Experience building and implementing audit plans.
• Experience with EHR systems (Epic preferred).
• Experience with Centricity Business, and MyBI.

Knowledge, Skills and Abilities:

• Ability to communicate effectively, both in writing and orally.
• Ability to establish and maintain effective working relationships with a diverse group of employees and stakeholders at all levels throughout the institution.
• Demonstrated commitment and leadership ability to advance diversity and inclusion.
• Strong organizational and time management skills.
• Strong verbal, written, and presentation skills.
• Strong project management skills and proficient in creating and maintaining detailed project plans.
• Independent decision-making skills with the capacity for critical thinking and problem-solving.
• Strong interpersonal skills and the ability to navigate complex relationships.
• Ability to maintain confidentiality and demonstrate a high level of discretion in dealing with sensitive information.
• Familiarity with Lean, Six Sigma, or other process improvement methodologies.
• Proficiency with project management tools, spreadsheets (Excel), and communication platforms (e.g., Outlook, Microsoft Teams).

How to Apply:

For full consideration, please submit the following document(s):

1. A letter of interest describing relevant job experiences as they relate to listed job qualifications and interest in the position.

2. Curriculum vitae / Resume

3. Three to five professional references, including name, address, phone number (mobile number if appropriate), and email address.

Questions should be directed to: Lydia Lyon, lydia.lyon@cuanschutz.edu

Screening of Applications Begins:

Applications will be accepted until finalists are identified, but preference will be given to complete applications received by February 21^st, 2025. Those who do not apply by this date may or may not be considered.

Anticipated Pay Range:

The starting salary range (or hiring range) for this position has been established as $67,611 - $86,001.

The above salary range (or hiring range) represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting. This position may be eligible for overtime compensation, depending on the level.

Your total compensation goes beyond the number on your paycheck. The University of Colorado provides generous leave, health plans and retirement contributions that add to your bottom line.

Total Compensation Calculator: http://www.cu.edu/node/153125

ADA Statement:

The University will provide reasonable accommodations to applicants with disabilities throughout the employment application process. To request an accommodation pursuant to the Americans with Disabilities Act, please contact the Human Resources ADA Coordinator at hr.adacoordinator@cuanschutz.edu.

Background Check Statement:

The University of Colorado Anschutz Medical Campus is dedicated to ensuring a safe and secure environment for our faculty, staff, students, and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees.

Vaccination Statement:

CU Anschutz strongly encourages vaccination against the COVID-19 virus and other vaccine preventable diseases. If you work, visit, or volunteer in healthcare facilities or clinics operated by our affiliated hospital or clinical partners or by CU Anschutz, you will be required to comply with the vaccination and medical surveillance policies of the facilities or clinics where you work, visit, or volunteer, respectively. In addition, if you work in certain research areas or perform certain safety sensitive job duties, you must enroll in the occupational health medical surveillance program.