UCSD Layoff from Career Appointment: Apply by 04/20/2017 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.
This position will remain open until filled.
Under minimal supervision, the incumbent utilizes clinical and/or coding expertise to enhance revenue integrity by performing concurrent or retrospective charge capture audits. These audits compare medical record documentation to the itemized bill in accordance to governmental, coding and billing rules and regulations to identify opportunities for improved compliance and revenue opportunities through more effective documentation or improved charge capture processes.
Actively participates in compliance activities as required to assure revenue integrity. Maintains a working knowledge of the revenue cycle process to aid in the implementation of regulatory standards while accurately complying with billing guidelines. Participates in ongoing coordination and resolution of revenue issues as they arise.
Analyzes audit results to identify patterns, trends, variances and opportunities to improve revenue integrity. Coordinates with other Revenue Integrity team members and other departments as necessary to ensure identified patterns and trends are provided as feedback to improve revenue integrity going forward. Works assigned work queues to effectively manage charge audit issues and resolve issues in a timely fashion. Ensures audits are conducted accurately and timely to minimize delays in billing and eliminate potential denials or compliance related issues. Contributes to a positive working environment and performs other duties as assigned to enhance the overall efforts of the organization. Complies with HIPAA and Code of Conduct policies. Performs other related analysis functions as required.
Graduation from college with a major in related field; or an equivalent combination of education and experience.
Four (4) years of related administrative analysis experience in a clinical or financial role, or strong work experience in coding, charge description master (CDM), or billing.
Clinical and/or coding expertise with a demonstrated ability to perform concurrent or retrospective charge capture audits.
Knowledge of coding and billing rules and regulations.
Working knowledge of the revenue cycle process, regulatory standards, and billing guidelines.
Knowledge of various coding systems utilized in healthcare (CPT, HCPCS, ICD-9).
Working knowledge of HIPAA and Code of Conduct policies and compliance.
Ability to analyze audit results to identify patterns, trends, variances and opportunities to improve revenue integrity.
Experience includes working a in a collaborative environment.
Highly proficient with MS Office: Excel, Word, PowerPoint, Outlook.
Ability to maintain strict confidentiality.
Excellent communication skills with the ability to communicate clearly both verbally and in writing and be able to articulate complex ideas for all levels of audiences.
Be a self-starter who is accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization.
Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountability.
CPC-H, CPC, CCS completion within the first six months of hire.
Demonstrated knowledge of UB-04 revenue/billing codes.
Familiar with UCSD systems, applications, policies, and procedures.
- Must be able to work various hours and locations based on business needs.