Healthcare Revenue Integrity Auditor

University of California, Irvine; Irvine (CA); On-site; USD 90,000 - 130,000; Full time

Job summary

University of California, Irvine seeks a Revenue Cycle Auditor to join its health system. The incumbent will perform comprehensive audits of hospital and professional billing, assess regulatory and compliance risks, and identify opportunities to improve denial prevention and process controls.

The role requires extensive knowledge of medical terminology, coding certifications, and experience with CMS guidelines, Medicare/Medicaid products, and different payer contracts.

Qualifications

• Proficient Excel, Word, and PowerPoint; able to manage data and present findings.
• Must hold CPC, COC, or AHIMA credentials.
• Experience reviewing CMS, Commercial and Government payer coding and payment requirements.
• Five years’ hospital and physician billing experience.
• Five years’ auditing in acute care hospital and academic setting.
• Knowledge of ICD-10-CM and CPT coding conventions.
• Knowledge of DRG/APC reimbursement.
• Excellent written and verbal English communication.
• Ability to lead and collaborate across teams.
• Familiarity with audit software.

Responsibilities

• Perform comprehensive revenue cycle audit reviews identifying risks.
• Evaluate internal controls and compliance with billing guidelines.
• Prepare audit reports quantifying impacts on gross and net revenue.
• Provide education and corrective action recommendations to staff.

Skills

Excel

Word

PowerPoint

CPC

COC

AHIMA

CMS guidelines

Audit software

Communication skills

Team leadership

Tools

Epic EMR

Job description

University of California, Irvine seeks a Revenue Cycle Auditor to join its health system. The incumbent will perform comprehensive audits of hospital and professional billing, assess regulatory and compliance risks, and identify opportunities to improve denial prevention and process controls.

The role requires extensive knowledge of medical terminology, coding certifications, and experience with CMS guidelines, Medicare/Medicaid products, and different payer contracts.