HB Second Level Reviewer - Remote - 142116

UC San Diego; San Diego (CA); Remote; USD 82,000 - 148,000; Full time

Job summary

UC San Diego Health's Revenue Cycle department seeks an experienced auditor to review and remediate coding deviations in inpatient facilities. You will train coding staff, educate other workforce members, and oversee query generation to assure timely responses and proper documentation.

You will represent coding leadership at interdisciplinary meetings, ensuring data integrity and high-quality data released to HEDIS, CMS and Vizient.

Qualifications

• Seven (7) years of related auditing experience in a large academic hospital system, or a Bachelor's Degree in related area plus three (3) years auditing experience.
• Thorough knowledge of auditing theories, internal control, and professional auditing standards.
• Gathers, analyzes, and performs moderately complex audit assignments; learning advanced concepts.

Responsibilities

• Review, audit, and remediate deviations from compliant inpatient facility coding.
• Train the coding staff and educate others on coding, grouping, and documentation.
• Oversee generation and approvals of queries to ensure timely responses and data integrity.
• Represent coding leadership at optimization, CDI, and interdisciplinary meetings.
• Ensure the highest data integrity and external data quality released to HEDIS, CMS and Vizient.

Skills

Auditing experience

Communication skills

Enterprise software

Relational databases

Auditing standards

Education

Bachelor's Degree in related area

Tools

Audit software

Relational databases

Job description

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

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 Inpatient facility 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. May 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.

MINIMUM QUALIFICATIONS

• 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.

PREFERRED QUALIFICATIONS

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

• Experience and proven success in practices, procedures, and concepts of the of the healthcare revenue cycle and its component operations, including ICD-10, SOI/ROM, HAC, PSI and query identification, writing, and monitoring.

• Minimum of three (3) years Inpatient Facility auditing experience of coders.

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

• Interaction with physicians.

SPECIAL CONDITIONS

• Must be able to work various hours and locations based on 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).