HB Inpatient Second Level Reviewer - Remote - 135203

University of California - San Diego Medical Centers; San Diego (CA); Remote; USD 77,000 - 140,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated professional to join their Revenue Cycle department. This role is crucial for maintaining data integrity and ensuring high-quality coding standards. You will engage in auditing practices, train staff, and represent coding leadership in various meetings. If you thrive in a fast-paced environment and are passionate about problem-solving and customer service, this opportunity is perfect for you. Join a diverse team committed to delivering outstanding patient care and making a difference in the community.

Qualifications

• 7 years of auditing experience or Bachelor's Degree plus 3 years in large academic hospital.
• Experience in healthcare revenue cycle practices including billing and collections.

Responsibilities

• Reviewing and auditing inpatient facility coding deviations.
• Training coding staff and educating team members in coding and documentation.

Skills

Auditing in large academic hospital system

Healthcare revenue cycle practices

Billing and collections

Charge capture

Third-party reimbursements

Cash management

Inpatient facility coding audit

Education

Bachelor's Degree in related area

Tools

ICD-10

Query management

Job description

UCSD Layoff from Career Appointment: Apply by 04/24/25 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.

Special Selection Applicants: Apply by 05/06/25. Eligible Special Selection clients should contact their Disability Counselor for assistance.

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

DESCRIPTION

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 committed to quality, collaboration, and continuous improvement, enabling us to deliver the highest standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment, welcoming individuals passionate about problem-solving and customer service.

This role involves reviewing, auditing, and remediating deviations from compliant inpatient facility coding, training coding staff, and educating other team members in coding, grouping, and documentation. The position oversees the generation and approval of queries to ensure timely and appropriate responses, and ensures all coding work and workflows meet quality standards. The role may also involve representing coding leadership at optimization, CDI, and interdisciplinary meetings, with a focus on maintaining data integrity, avoiding denials, and ensuring high-quality external data for HEDIS, CMS, and Vizient reporting.

MINIMUM QUALIFICATIONS

• Seven (7) years of related auditing experience, such as auditing in a large academic hospital system, or a Bachelor's Degree in a related area plus three (3) years of relevant auditing experience in a large academic hospital system.
• Experience and proven success in healthcare revenue cycle practices, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

PREFERRED QUALIFICATIONS

• Current credentials such as RHIT, RHIA, CCS, or a combination thereof.
• Experience in practices, procedures, and concepts of the healthcare revenue cycle, including ICD-10, SOI/ROM, HAC, PSI, and query management.
• At least three (3) years of inpatient facility coding audit experience.
• Experience working in Level I Trauma and academic/research hospital settings is a plus.
• Experience interacting with physicians.

SPECIAL CONDITIONS

• Ability to work various hours and locations based on business needs.
• Employment is contingent upon a criminal background check and pre-employment physical.

Pay Transparency Act

Annual full pay range: $77,000 - $139,200 (pro-rated if less than 100% appointment).

Hourly equivalent: $36.88 - $66.67.

Factors influencing compensation include experience, skills, education, licensure, certifications, and organizational needs. The listed pay scale is the budgeted range and may be broader based on internal equity, budget, and collective bargaining agreements.