112907 - Lead PB Second Level Reviewer - Remote
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#112907 Lead PB Second Level Reviewer - RemoteFiling Deadline: Mon 12/6/2021
For the safety and well-being of the entire university community, the University of California requires, with few exceptions, that all students, faculty and staff be vaccinated against the COVID-19 virus and influenza before they will be allowed on campus or in a facility or office. For more information visit: Flu Vaccine Mandate / COVID Vaccine Policy
UCSD Layoff from Career Appointment: Apply by 11/24/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 12/06/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.
Responsible for review, audit, and remediation of any deviation from compliant coding, training the coding and auditing staff, and educating other workforce members in coding, grouping, and proper documentation. Supports the SLR auditing team as the subject matter expert on complex multi-specialty coding cases. Assists with overseeing the generation and approval of coding queries to ensure a timely and appropriate response. Assists SLR Manager with monitoring all auditing assignments and workflows to ensure the intended results are achieved. Represents coding leadership at optimization, CDI, and other interdisciplinary meetings. Conducts quality reviews of audit team to ensure the highest level of data integrity, denial avoidance due to coding, and the highest quality of external data released to HEDIS, CMS, UHC.
Nine (9) years of multi-specialty provider-based coding and auditing experience and training; OR a Bachelor’s Degree in related area plus five (5) years of multi-specialty provider-based coding and auditing experience and training.
Current Credentials as CPC, CPMA, CCS-P, or combination.
Experience and proven success in practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including ICD-10, CPT, HCPCS coding, SOI/ROM, HAC, PSI, Risk Adjustment/HCC and query identification, writing, and monitoring.
- Certified in Healthcare Compliance.
- Experience in leading/managing projects and team members.
- Excellent organizational and critical thinking skills.
- Interaction with physicians.
- Must be able to work various hours, days, shifts, on-call and locations based on the 24-hour Medical Center's business needs.
- Employment is subject to a criminal background check and pre-employment physical.
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, and several outpatient clinics. UC San Diego Medical Center in Hillcrest is a designated Level I Trauma Center and has the only Burn Center in the county. We invite you to join our dynamic team!
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