Outpatient Revenue Cycle Analyst 3 - Health Information - FT Days

University of California, Irvine•Irvine, CA

7d•Onsite

About The Position

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. 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.

Requirements

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
Must be able to provide proof of work authorization

Nice To Haves

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

Responsibilities

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.
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.