Reimbursement Auditor, Full-Time

Job Description

Job Description

Position Highlights:

• Position: Compliance Reimbursement Auditor
• Job Type: Full-Time

R esponsibilities:

• Coordinate with internal departments and external facilities to determine the appropriate payor for services
• Review payments received for Oncology services to ensure we are receiving proper reimbursement from payers
• Review all Oncology/Research related denials and coordinate appeals with appropriate Business Office Team/s
• Ability to review and update current HCPCS codes as they are related to Oncology
• Participation in hospital wide coding and charge master meetings
• Subject Matter Expert and internal Monitoring to ensure research billing compliance
• Collaborating closely with the Financial Services team who will be responsible for completing final coding and billing.
• Providing CPT codes for all study procedures that are billable to sponsor, patient, and/or Insurance
• Management and Communication of Medicare Coverage Analysis for GVO Clinical Trials
• Defining and improving processes to ensure quality and efficiency
• Collaboration with Research Team for Sponsor Billing
• Involvement in implementing policies and processes for internal and external workflows to ensure complaint, quality and efficient practices related to Oncology and Research Billing and Reimbursement
• Acts as a liaison for any Oncology or Research billing questions, changes and/or concerns.
• Escalates Oncology or Research billing questions, changes and/or concerns appropriately.
• Verify determinations of whether proposed clinical research studies are a qualifying clinical trial as defined by Medicare Clinical Trial Policy

Requirements:

• High school diploma or equivalent; Bachelor’s degree in Science, healthcare or related field preferred. With at least 5 years of inpatient/outpatient coding experience OR equivalent combination of education and experience.
• Certification in one of the following organizations is required: AHIMA, AAPC (RHIT and/or CCS,)
• ACRP / SOCRA certification within 6 months of being eligible (SOCRA is preferred)

Compensation:

• $27.00 - $31.05 per hour, depending on education and experience.
• Discretionary bonuses, relocation expenses, merit increase, market adjustments, recognition bonuses, and other forms of discretionary compensation may be available.

Benefits:

• Medical, dental, vision insurance
• Life Insurance
• Free Parking
• Paid time off
• Education assistance
• 403(b) with employer matching
• Wellness Program
• Additional benefits based on employment status

Additional Information:

• Relocation: Must relocate to Grand Junction, CO 81505 after starting work.
• Work Location: In-person/onsite
• This position will be posted through August 31, 2026, and may remain open longer until filled.

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Community Hospital recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, Community Hospital 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. Community Hospital 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.