HB Second Level Reviewer - Remote - 142116

University of California - San Diego Medical Centers; United States; Remote; USD 82,000 - 148,000; Full time

Job summary

University of California - San Diego Health is seeking an experienced Auditor to review, audit, and remediate deviations in inpatient facility coding. You will train coding staff, educate the workforce on coding, grouping, and documentation, and oversee query generation and approvals to ensure timely and accurate responses.

The role requires strong knowledge of audit standards, enterprise software, and relational databases, with the option for remote work as part of the engagement.

Qualifications

• Seven (7) years of related auditing experience in a large academic hospital system or a Bachelor's Degree plus three (3) years auditing experience.
• 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.
• Strong interpersonal and communication skills to present sensitive information with diplomacy and in a clear and concise manner.
• May require specialized expertise in enterprise software and relational databases.

Responsibilities

• Review, audit, and remediation of deviations from compliant inpatient facility coding.
• Train the coding staff and educate workforce in coding, grouping, and documentation.
• Oversee generation and approvals of queries to ensure timely, appropriate response.
• Ensure all coding assignments and workflow achieve the intended result.
• Represent coding leadership at optimization, CDI, and interdisciplinary meetings.

Skills

Auditing

Internal controls

Data analysis

Communication skills

Relational databases

Enterprise software

Education

Bachelor's degree in related area

RHIT/RHIA/CCS credentials preferred

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).