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Auditor & Process Educator

Location: Lone Tree, CO, United States
Category: Professional/Management
Job Type: Full Time
Job ID: 60545
Date Posted: Sep 9, 2022

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Description

Auditor and Process Educator

This is a full-time, exempt/salaried position on UCHealth Plan Administrators team based in Lone Tree CO, with a one day a week work from home opportunity. Performs all quality assurance functions, including claim auditing, check run auditing, and plan build auditing.  Identifies process improvement based on audit results.  Trains staff on processes, maintenance and updates. Provides enterprise training and education on procedure and policies.


Job duties

Audits and assesses staff to assure proficiency in practices that align with regulatory audits and guidelines, and employer group process requirements.

Manages the quality assurance workflow to ensure on-time delivery of review findings.

Trains staff to ensure system-wide consistent operational processes, in alignment with optimal performance metrics. 

Maintains training manuals, job aids, policies and procedures, documented work-flows, and implementation check-lists.

Develops, maintains and provides training for ancillary systems.


Requirements

High School diploma or GED

5 years of relevant experience


Preferred

Proficient at performing comprehensive quality assurance reviews of professional and facility claims processed by claims examiners and reporting findings

Experience with overpayments and refunds

Knowledge of reinsurance as it applies to self-insured plans

Experience in administration of self-funded plans


The pay range for this position is: $27.61 - $41.41 / hour.  Pay is dependent on applicant's relevant experience. 


UCHealth offers a Five Year Incentive Bonus to recognize employee’s contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years’ employment.


UCHealth offers their employees a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical, dental and vision coverage; retirement plans; paid time off; employer-paid life and disability insurance with additional buy-up coverage options; tuition and continuing education reimbursement; and a full suite of voluntary benefits such as identity theft protection and pet insurance. Our employees and their family members have full access to our Employee Assistance Program, which includes up to 5 free counseling visits and work/life solutions, such as one free legal consultation. In addition, other emotional counseling support is available depending upon their need.


At UCHealth, we do things differently

We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve.   As Colorado’s largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it’s a passion.

Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy.  We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we’ll do everything in our power to make sure you grow and have a meaningful career. There’s no limits to your potential here.

  

Be Extraordinary. Join Us Today!

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution.  As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements.  No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status.  UCHealth does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.


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