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Provider Medical Bill Auditor
Pinnacol Assurance

Location: Denver, Colorado
Work Setting: Other
Job Function:
Job Type:
Salary Range: $32.90-$34.50


Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. And while we may be a little biased, we believe that our work shapes communities and changes lives.
We have big hearts and love big ideas. We’ve been around for more than 100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways. We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence.

Job Description

What you’ll do:
Ensure that providers are in compliance with Colorado Division of Workers’ Comp rules and regulations and industry coding guidelines.

What you can expect:

– Identify provider and facility billing error trends and document trends to develop training and provider action plans
– Educate providers and vendors when trends are identified to prevent future errors and coordinate with Provider Network Management Team when appropriate
– Run reports to identify issues to be monitored and addressed
– Maintain accurate documentation of audit findings including billing trends, recommendations for improvements, overpayments, and collection of funds
– Present findings and make recommendations to management for improvements based on audit results
– Collaborate with Provider Network Management Team on practice variation initiatives to reduce unnecessary medical spending
– Notify quality analysts of any potential system issues or enhancements identified during the audit process
– Provide support and feedback as a subject matter expert regarding coding questions from internal and external customers in a timely manner.
– Remain current on coding changes; communicate all coding changes to team members
– Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintain current certification(s) and working knowledge of DOWC and CPT coding guidelines.
– Inform leadership of any suspicious or fraudulent billing
– Assist with special projects
– Perform other duties as assigned

Required Qualifications

What you need to be successful:
Bachelor’s Degree is strongly preferred. Relevant work experience (similar kind of work at a similar level of work as described in the essential duties) may be substituted for the bachelor’s degree. Completion of a degree is encouraged and supported. Five years of experience in medical coding/bill payment, and auditing is required. Basic Excel/Google Sheets competency is required, and advanced skills are preferred. Strong written and verbal skills are required. Coding Certification (CPC) and/or Payer Certification (CPC-P) certification (AAPC or AHIMA) is required. Extensive knowledge of anatomy and physiology and medical terminology is required. This position is mostly remote, but you must be able to visit provider clinics as needed.

Preferred Qualifications

Knowledge of Workers’ Compensation guidelines and rules is strongly preferred.


We can’t do our work without people like you.
Our employees are extraordinary and committed to making a difference. Here’s some of the ways we show our appreciation.
Our benefits go beyond the basics. You’ll get to choose from diverse benefit offerings for medical, dental and vision.
We care about each other. We enjoy a positive, collaborative work environment. We are hard workers and high performers.
We love who you are. Pinnacol is on a journey to embody diversity, equity and inclusion. We’re committed to creating a culture that deeply values differences, where everyone feels like they belong.
Take a day (or 20!) off. Enjoy 20 paid days off your first full year plus 9 paid holidays.
Take care of yourself. Sign up for unique wellness programs, including on-site, company-paid fitness facilities and classes
Get your learning on. We promote a learning culture to help you master your current job and cultivate the skills of the future through a variety of on-site, online, and off-site professional development opportunities.
Give back and get paid. Through our employee volunteer program, Pinnacol in Action, employees receive paid time off to volunteer with Colorado nonprofits.
Share in our success. You’ll have the opportunity to earn a quarterly incentive, up to 12 percent of your annual base salary, when your team exceeds their goals and objectives.

When we find the right person, we try to put our best foot forward with an offer that excites you. We consider what you’d like to be paid, the skills and experience you bring, what similar jobs pay in the Denver area and make sure there’s equal pay for equal work among those you’ll be working with. The compensation amount for this role is targeted at $32.90-$34.50 per hour. Final offer amounts are determined by multiple factors including your experience and expertise and may vary from the amounts listed above.

Want to love your work? Apply today!

Pinnacol is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email

Instructions for Resume Submission

Please submit your resume at this link –

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Posted: April 4, 2023 at 12:17 PM
Post ID: 77497

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