EPIC Quality Auditor

Job Summary University Medical Billing (UMB) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too. We are looking for an experienced EPIC Quality Auditor to join our team. As the EPIC Quality Auditor, you will be responsible for examining and analyzing information systems operations to identify opportunities for improvement and assess risks. Participating in audit planning and execution. Evaluating policies and procedures to ensure appropriate internal controls surrounding information systems are maintained. Developing strategies and providing recommendations on strengthening controls, mitigating risk, and implementing corrective actions. Documenting and reporting audit findings to management. May require Certified Information Systems Auditor (CISA) designation. May assist with financial and operational audits and ensure compliance with existing regulations as they relate to information systems. Employment Requirements Employment is contingent on the successful completion of a background check and adherence to departmental policies, including the Telecommuting Agreement requiring a distraction‑free and HIPAA‑compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M‑F, approximately 8am to 5pm Mountain Time) regardless of time zone. New hires are required to provide their own monitors (two) and reliable internet service. Compensation & Benefits The starting salary for this position is $75,000 to $85,000 per year, depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University’s comprehensive benefit package that includes 90% employer‑paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more. Responsibilities Review, analyze, and validate professional fee billing accuracy within Epic Resolute PB, including charge entry, charge routing, claim edits, denials, and related billing workflows, to identify opportunities for improvement and assess risk. Participate in audit planning and execution by performing audits of system automations, system updates, new business workflows, charge capture processes, coding workflows, and claims to confirm they are functioning as intended and meeting coding, billing, payer, data policy, and government regulatory requirements. Evaluate policies, procedures, workflows, and system processes to ensure appropriate internal controls are maintained and audit activities support compliance with coding, billing, payer requirements, data policies, and government regulations. Conduct 30-, 60-, and 90‑day post‑finalization reviews of implemented system or workflow changes to validate intended outcomes, identify gaps, assess risk, and confirm sustained performance. Audit team‑completed operational tasks, such as charge reconciliation and charge capture review, against approved procedures to confirm accuracy, completeness, appropriate controls, and expected billing outcomes. Analyze claims, charge data, denials, payment trends, coding patterns, and report details to identify revenue loss, coding errors, workflow failures, system issues, control gaps, or opportunities for improvement. Document and report audit findings to management and stakeholders, including recommendations to strengthen controls, mitigate risk, support corrective actions, and improve coding, billing, and system workflow performance. Other duties as assigned. Minimum Qualifications EQUIVALENCY STATEMENT: 1 year of higher education can be substituted for 1 year of directly related work experience (Example: bachelor’s degree = 4 years of directly related work experience). Department may hire employee at one of the following job levels: Information Systems Auditor, II: Requires a bachelor’s (or equivalency) + 4 years or a master’s (or equivalency) + 2 years of directly related work experience. Information Systems Auditor, III: Requires a bachelor’s (or equivalency) + 6 years or a master’s (or equivalency) + 4 years of directly related work experience. Preferences Foundational knowledge of healthcare delivery and billing processes. Experience working in EPIC implementation or system support, claims data, spreadsheets, and reporting tools. Minimum 2 years of coding experience in multiple specialties, AHIMA or AAPC Certification required. Strong knowledge of CPT, HCPCS, ICD‑10‑CM, modifiers, medical necessity, payer policy requirements, and professional billing workflows. Experience auditing claims, charges, coding, documentation, denials, edits, or billing system processes. Proficiency with electronic health records and billing systems, claims data, spreadsheets, and reporting tools. Ability to interpret regulatory guidance, payer policies, coding guidelines, and operational procedures. Experience working effectively in a remote environment. Disclaimer This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job. Equal Employment Opportunity Consistent with state and federal law, the University of Utah does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy‑related conditions, genetic information, or protected veteran’s status. The University of Utah does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both. To request a reasonable accommodation for a disability or if you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity and Title IX ( OEO ). More information, including the Director/Title IX Coordinator’s office address, electronic mail address, and telephone number can be located at the: University of Utah Non‑Discrimination page. #J-18808-Ljbffr