Revenue Integrity Auditor - Hospital Billing

UC Irvine; Irvine (CA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical insurance

Retirement savings plan

Discounts and perks

Job summary

UCI Health is a leading academic health system in California seeking a Revenue Cycle Auditor to identify risk areas and assess regulatory compliance. The role focuses on hospital and physician billing, charge data, and denial trends, with an emphasis on improving educational opportunities and implementing corrective measures.

The incumbent will review medical record documentation, coding data, and denial trends, applying extensive knowledge of ICD-10-CM & CPT conventions and DRG/APC

Qualifications

• Proficient EXCEL, WORD, PowerPoint skills.
• Must possess multiple current Coding Certifications (CPC/COC/AHIMA).
• Must possess experience reviewing CMS and payer coding rules.
• Five years’ hospital and physician billing experience.
• Excellent written and verbal English communication.

Responsibilities

• Perform comprehensive Revenue Cycle audit reviews and identify risks.
• Evaluate internal controls for regulatory and billing compliance.
• Prepare audit reports quantifying impacts on gross and net revenue and drive corrective actions.

Skills

Excel

Word

PowerPoint

Medical terminology

CMS payer knowledge

DRG/APC knowledge

Customer service

Communication skills

Team leadership

Decision making

Education

CPC/COC/AHIMA

Tools

Epic EMR

Audit software packages

Job description

UCI Health is a leading academic health system in California seeking a Revenue Cycle Auditor to identify risk areas and assess regulatory compliance. The role focuses on hospital and physician billing, charge data, and denial trends, with an emphasis on improving educational opportunities and implementing corrective measures.

The incumbent will review medical record documentation, coding data, and denial trends, applying extensive knowledge of ICD-10-CM & CPT conventions and DRG/APC