Outpatient Revenue Cycle Analyst 3 - Health Information - FT Days

UC Irvine; Irvine (CA); On-site; USD 85,000 - 110,000; Full time

Job summary

UCI Health is seeking an Outpatient Coding Auditor to join our team. You will lead rigorous audits of outpatient records, identify discrepancies, and collaborate with physicians and staff to capture accurate documentation and compliant billing.

The role requires strong CPT/HCPCS/ICD-10-CM knowledge, experience with EPIC and 3M 360 Encompass, and a commitment to high ethical and professional standards. A CCS certification and a Bachelor's degree are preferred.

Qualifications

• 3+ years' outpatient coding/auditing in an acute care hospital.
• In-depth CPT/HCPCS/ICD-10-CM knowledge and outpatient regulations.
• Experience with EPIC and 3M 360 Encompass.
• Strong written and verbal English communication skills.
• Ability to educate and train staff with high ethical standards.

Responsibilities

• Conduct departmental and interdepartmental coding audits.
• Review records and confer with physicians and staff to capture accurate documentation.
• Provide feedback and educational support to outpatient coding staff.
• Ensure adherence to regulatory requirements and CPT/APC payment rules.

Skills

Revenue Cycle

Analytics

Communication

Customer Service

Problem Solving

Time Management

Detail Oriented

Independent Worker

Education

Bachelor's Degree

CCS Certification

Tools

EPIC

3M 360 Encompass

Job description

Who We Are

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary: The Outpatient Coding Auditor reports to the Outpatient Coding Manager and is primarily responsible for conducting rigorous departmental and interdepartmental coding audits to ensure adherence to Federal and State regulations and identifying coding discrepancies in acute care outpatient services. Review records, conferences with physicians and medical center staff to capture accurate documentation. Conduct quality and CPT/APC payment reviews; audit documentation for discrepancies, coding errors, and billing issues; and provide feedback and educational support to outpatient coding staff and external departments. Assists in the development and enforcement of outpatient coding policies. Engage in ongoing education to stay up-to-date with coding guidelines, regulatory requirements, and billing regulations.

What It Takes to be Successful

Required Qualifications

• Thorough understanding of the issues, processes, reporting instruments, metrics, analytics, and other tools and techniques involved with measuring and analyzing the revenue cycle
• Thorough knowledge of practices, procedures, and concepts of the healthcare revenue cycle and its component operations (e.g., billing, collections, charge capture, contractual adjustments)
• Strong analytical skills to assess and resolve outpatient coding system errors
• Proven ability to work with managers, serving as a technical resource, providing recommendations and advice on regulatory changes, industry trends and developments in revenue cycle management
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Minimum three (3) years' outpatient coding/auditing experience in an acute care hospital
• In-depth knowledge of CPT, HCPCS, ICD-10-CM, and outpatient regulatory requirements
• Familiarity with EPIC and 3M 360 Encompass software
• Excellent written and verbal English communication skills
• Demonstrated attention to detail, organization, ability to effectively manage time and competing priorities, and see tasks through to completion
• Demonstrated ability to problem solve, analyze data for trends, and develop actions in response to findings
• Demonstrated ability to interpret and convey complex clinical financial information in a clear, concise manner
• Demonstrated ability to conduct coding education and training sessions effectively
• Commitment to maintaining high ethical and professional standards
• CCS certification
• Bachelor's degree in related area and / or equivalent experience / training
• Ability to work independently and be a self-starter
• Ability to maintain a work pace appropriate to the workload
• Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications

• Knowledge of University and medical center organizations, policies, procedures and forms
• Credentialed through the American Health Information Management Association (RHIT/RHIA)

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization