HB Inpatient Second Level Reviewer - Remote - 135203 Remote

Scripps Institution Of Oceanography • San Diego, CA

226d • $77,000 - $139,200 • Remote

About The Position

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 represent 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.

Requirements

• Seven (7) years of related auditing experience in a large academic hospital system, education/training, OR a Bachelor's Degree in a related area plus three (3) years auditing experience.
• Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

Nice To Haves

• Current Credentials as RHIT or RHIA, or CCS, or combination.
• Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle 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.
• Interaction with physicians.

Responsibilities

• Review, audit, and remediate deviations from compliant Inpatient facility coding.
• Train coding staff and educate other workforce members in coding, grouping, and proper documentation.
• Oversee the generation and approvals of queries to assure timely and appropriate responses.
• Ensure all coding assignments and workflow achieve intended results.
• Represent coding leadership at optimization, CDI, and other interdisciplinary meetings.
• Assure the highest level of data integrity and denial avoidance due to coding.
• Ensure the highest quality of external data released to HEDIS, CMS, and Vizient.

Benefits

• Annual Full Pay Range: $77,000 - $139,200.
• Hourly Equivalent: $36.88 - $66.67.
• Employment is subject to a criminal background check and pre-employment physical.
• Compliance with the Policy on Vaccination Programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree