HB Outpatient Second Level Reviewer - Remote - 138000

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.

Candidates hired into this position may have the ability to work remotely., * 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.

• Thorough knowledge of the audit profession, theories and systems of internal control, and professional auditing standards.
• Gathers, organizes and performs analysis for moderately complex audit assignments. Working on mastering more advanced audit concepts and applications in the completion of assignments.
• Strong interpersonal and communication skills to present sensitive information with diplomacy and in a clear and concise manner. Presents to a wide variety of audiences, including senior management and external agencies.
• May require specialized expertise in enterprise software and relational databases., * 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 billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• 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.

SPECIAL CONDITIONS

• 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.

Pay Transparency Act

Annual Full Pay Range: $81,600 - $147,800 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $39.08 - $70.79

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable). UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

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.