Revenue Integrity Auditor - Revenue Integrity - FT Days (Remote) - 37897-1A

Updated: Sep 8, 2022
Location: Orange
Job Type:
Department: Revenue Integrity

UC Title: REVENUE CYCLE HC ANL 3
Position Number: 40908050
Reports to: Asst Dir of Revenue Integrity
Working Title: Revenue Integrity Auditor
Cost Center: Revenue Integrity (428534)
Bargaining Unit: No Bargaining Unit
FLSA: Exempt
Date Created: 6/14/2022
Job Code: 007589
Hours: 40
Shift: Not Applicable
FTE: 1
 
 
Position Summary: 
The incumbent is responsible to perform routine Revenue Cycle audit reviews, identify areas of risk, determine regulatory and compliance risk, audit necessity, as well as denial prevention opportunities. This position will conduct comprehensive audits to include; review of denials, charge trends, medical records reviews and coding, in order to make risk and impact determinations.  The incumbent must have knowledge of medical terminology and possess a coding certification, as well as have experience with various health plan products (Medicare, Medi-Cal, HMO, PPO, Managed Care, etc.) private insurance and CMS guidelines.  Previous experience in a hospital setting with split fee billing with emphasis on hospital billing.   This position will be responsible to produce comprehensive audit findings that include quantifiable impact, identify areas of opportunity for education, as well as a process improvement plan.
 
 
Salary Range:
 
Annual Rate  Minimum  $59,200.00                           Midpoint $86,700.00                           Maximum  $114,200.00
 
Required Qualifications:
Ability to maintain a work pace appropriate to the workload
Must demonstrate customer service skills appropriate to the job
Excellent written and verbal communication skills in English
Ability to establish and maintain effective working relationships across the Health System , COM, UCI Research Administration and other UC System campuses
Competent knowledge and experience with Microsoft Office computer applications,  i.e. Word, Excel
Familiarity of audit software packages
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Must possess a current Coding Certification (CPC, COC, or AHIMA equivalent)
Three years experience in hospital billing, technical charging practices.
Must possess experience reviewing and interpreting CMS, Commercial and Government payer coding and payment requirements.
Experience in providing both verbal and written feedback or education directly to clinical and/or billing staff regarding coding, charging, documentation, payor authorization, and claim processing requirements.
Three years’ auditing experience working in acute care hospital with split billed setting
 
 
Preferred Qualifications:
Knowledge of University and Medical Center organizations, policies, procedures and forms
 
 
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
  • Legal Right to Work in the United States
  • Vaccination Policies
  • Smoking and Tobacco Policy
  • Drug Free Environment
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, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 nondiscrimination 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 [email protected] or at (949) 824-0500, Monday – Friday from 8:30 a.m. – 5:00 p.m.

 

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