Description The University of California Davis Health (UC Davis Health) Compliance Program is a comprehensive approach to promoting ethical and proper behavior in all matters related to the health system's business operations. The primary goal of the Compliance Program is to establish effective controls to recognize potential risks and promote adherence to applicable regulations, and internal policies and procedures. Inclusive in the Compliance program is external government audits.
Position Information Salary Range : $2513.60 to $5141.60 Salary Frequency : Bi-weekly No. of Positions : 1 Appointment Type : Career Percentage of Time : 100% Shift Hour : 08 Hours Location : Sherman Way Building City : Sacramento Union Representation : No Benefits Eligible : Yes
This is not an H1B opportunity. Qualified candidates may be interviewed at any time.
We offer exceptional employment benefits including medical, dental, and vision plans, generous paid vacations and holidays, excellent retirement savings and investment plans, continuing education, and reduced fee and scholarship programs.
Qualifications REQUIRED -Coding certification from AAPC or AHIMA --Ability to read, comprehend, interpret, and instruct others relative to State/Federal regulations, procedures and policies relating to coding, billing and reimbursement -Extensive technical knowledge of Centers for Medicare & Medicaid Services (CMS) Recovery Audit Program; to include program guidelines, hard-stop timelines, approved review issue for external auditors in the geographical area Strong organizational and time management skills; ability to handle multiple demands /deadlines and establish priorities -Self-sufficient, self-motivated with the ability to work independently with minimum supervision -Strong knowledge of medical terminology -Experience with billing criteria relative to CMS 1500 and UB-04 claims processing -Detail knowledge of healthcare documentation requirements, coding regulatory requirements, and healthcare billing -Must be able to read text for long periods of time from printed materials and/or computer
PREFERRED -Experience working in a Compliance capacity -Previous experience auditing, documentation, and billing -Demonstrated Epic systems knowledge -Knowledge of payer plan requirements, managed care environment, authorization processes, appointment scheduling, registration, and reimbursement contracts -Knowledge of UHDDS, OSHPD, Title 22, and the Joint Commission documentation guidelines sufficient to assess screening procedures and ensure coding compliance -Bachelor degree in public health, healthcare, policy, law or related field or extensive related experience
SPECIAL REQUIREMENT - THIS POSITION MAY BE SUBJECT TO A CRIMINAL BACKGROUND INVESTIGATION, DRUG SCREEN, LIVE SCAN FINGERPRINTING, MEDICAL EVALUATION CLEARANCE, AND FUNCTIONAL CAPACITY ASSESSMENT
Responsibilities The Government Audit Analyst (Regulatory and Compliance HC Spec 3) is responsible for the coordination of activities associated with government audits such as Medicare and Medicaid Recovery Audit Contractors (RACs), Comprehensive Error Rate Testing (CERTs), and Noridian Targeted Probe and Educate (TPEs). The Analyst is accountable for managing all the activities related to government audits including retrieving, reviewing, and submitting medical records, assessing the accuracy of the coding and provider documentation, and developing training as needed. Acts as the Compliance liaison for government audit contractors. Performs significant analysis of government audit denials and data management skills to ensure that all external audit requests are promptly responded to on behalf of UC Davis Health.
The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.
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UC Davis is the home of the Aggies — go-getters, change makers and problem solvers who make their mark at one of the top public universities in the United States. Since we first opened in 1908, we’ve been known for standout academics, sustainability and Aggie Pride as well as valuing the Northern California lifestyle. These themes are woven into our 100-plus-year history and our reputation for solving problems related to food, health, the environment and society.Our 5,300-acre campus is in the city of Davis, a vibrant college town of about 68,000 located in Yolo County. The state capital is 20 minutes away, and world-class destinations such as the San Francisco Bay Area, Lake Tahoe and the Napa Valley are within a two-hour drive.