EPIC Quality Auditor

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 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 provide recommendations on strengthening controls, mitigating risk, and implementing corrective actions. Documenting and reporting audit findings to management.

Responsibilities

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. Other duties as assigned.

Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires 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 what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.