HB Outpatient Second Level Reviewer - Remote - 131388

UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world - one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.

Responsible for review, audit, and remediation of any deviation from compliant coding, training the coding staff, and educating other workforce members in coding, grouping, and proper documentation. Oversees the generation and approvals of queries to assure a timely and appropriate response. Assures that all coding assignments and workflow achieves the intended result. Represents coding leadership at optimization, CDI, and other interdisciplinary meetings. Assure the highest level of data integrity, denial avoidance due to coding, and the highest quality of external data released to HEDIS, CMS and Vizient.

• Seven (7) years of related auditing experience i.e. auditing experience in large academic hospital system, education/training, OR a Bachelor's Degree in related area plus three (3) years auditing experience i.e. auditing experience in large academic hospital system, education/training.

• Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

• Current Credentials as RHIT or RHIA, or CCS, or combination.

• Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including ICD-10, CPT, HCPCS coding, Risk Adjustment/HCC and query identification, writing, and monitoring.

• Minimum of three (3) years Outpatient Facility auditing experience of facility coders to include Emergency Department (facility & profee), Infusion Center, Observation, and/or Same Day Surgery.

• Experience working for Level I Trauma & Academic/Research Facility is a plus.

• Interaction with physicians.

• Must be able to work various hours, days, shifts, on-call and locations based on the 24-hour Medical Center's business needs.

• Employment is subject to a criminal background check and pre-employment physical.

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

UC San Diego is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

For the University of California's Affirmative Action Policy please visit: https://policy.ucop.edu/doc/4010393/PPSM-20
For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.