HIM Physician Auditor - Full Time

Vail Health is a leading healthcare system based in Colorado, operating a modern 56-bed hospital and advanced medical services facility in Vail. The organization is seeking a HIM Physician Auditor to conduct detailed audits of physician documentation, coding, and billing practices. This role supports revenue cycle integrity by ensuring compliance with healthcare regulations, identifying documentation improvements, and educating clinical staff on accurate coding and billing standards.

Vail Health is seeking a HIM Physician Auditor to support clinical documentation integrity and regulatory compliance across physician services. This role focuses on auditing physician documentation, coding, and billing activities to ensure accuracy, completeness, and adherence to healthcare regulations and payer guidelines. The auditor works closely with providers, coding specialists, and compliance teams to identify discrepancies, recommend corrective actions, and strengthen documentation practices that support accurate reimbursement and regulatory compliance.

Responsibilities:
- Audit physician documentation and coding practices across multiple specialties for accuracy and compliance
- Review medical records to validate billed services, medical necessity, and identify documentation discrepancies
- Prepare detailed audit reports outlining findings, compliance issues, and corrective action recommendations
- Provide training and feedback to physicians and clinical teams on documentation improvement and coding standards
- Collaborate with compliance, coding, and clinical teams to address audit findings and implement improvements
- Monitor changes in healthcare regulations, coding standards, and payer policies to ensure ongoing compliance

Requirements:
- Minimum of 5 years experience in physician coding within a professional fee environment
- At least 5 years of experience in auditing or clinical documentation improvement roles
- Certification such as RHIT, CCS, CCS-P, CPC, or CPMA
- Strong knowledge of ICD-10-CM, CPT, HCPCS, and evaluation and management coding guidelines
- Experience reviewing medical records and validating billing accuracy
- Ability to communicate audit findings and compliance guidance to clinical staff effectively

Benefits:
- Competitive compensation with comprehensive health benefits
- Paid parental leave and childcare reimbursement
- Tuition assistance and certification reimbursement programs
- Retirement plan with employer matching and wellness benefits

This position supports high-quality healthcare operations by ensuring documentation accuracy and regulatory compliance within a modern healthcare system.