Clinical Revenue Analyst - Hybrid/Remote - 119426
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#119426 Clinical Revenue Analyst - Hybrid/RemoteExtended Deadline: Mon 12/5/2022
UC San Diego values equity, diversity, and inclusion. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.
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
This position is a contract/limited position with the possibility of extension/career conversion.
UCSD Layoff from Career Appointment: Apply by 10/13/2022 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 10/24/2022 Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position offers a hybrid work arrangement, which includes a combination of onsite and remote work.
The Department of Orthopaedic Surgery is a vibrant and growing Orthopaedic Surgery Department of 48 full-time faculty and 50 voluntary faculty, 4 physicians on MSP contracts, 32 trainees, and 34 staff that supports and participates in the academic, clinical, and research mission of UC San Diego. The Department generates over $12M in clinical revenue, and $5M (NIH & other) in research grants and contracts, with total annual expenditures exceeding $30M. The Department is a comprehensive orthopaedic group located in San Diego that offers a full spectrum of musculoskeletal clinical care, specializing in foot and ankle, hand, joint reconstruction, physical medicine and rehabilitation, spine, sports, and trauma. Research expertise includes advancements in muscle metabolism and physiology, neuromuscular bioengineering, intervertebral disc, and musculoskeletal physiology and epidemiology.
Under the direction of the Vice Chair for Administration, the Clinical Revenue Analyst will work independently and serve as an expert on professional fee coding and revenue management, funds flow management, provider education and documentation, and efficiency enhancement for the Department of Orthopaedic Surgery. Incumbent audits and reviews provider documentation and coding throughout billing process for accuracy, and acts as liaison with the health system and faculty practice group to mitigate queries and resolve billing delays. Assesses bill areas and funds flow for accuracy. Develops and implements provider education programs and opportunities, provides feedback and guidance to providers and ensures compliance to governmental, UC, compliance, and payor guidelines.
Position to oversee billing credentialing, clinical productivity reporting, and professional billing and revenue reports. Clinical Revenue Analyst manages related operations and projects, acting as a trusted advisor and partner to provider organizations to support clinical excellence and optimal revenue cycle and funds flow performance. Ensures all charges are captured by utilizing reports or processes on a daily basis and following up accordingly. Performs coding quality reviews on a monthly basis. Recommend, specify, develop, and supervise the implementation of policy changes that affect department Professional Fee income. Completes other duties as assigned.
7 years of relevant experience or a Bachelor's degree in related area and/or equivalent experience/training plus three (3) or more years of relevant experience.
Thorough knowledge of financial analysis and reporting techniques, and / or human resources policies and procedures for staff and academic employees. Experience in a provider educator role and the completion of billing packets and associated training.
Knowledge of a variety of administrative operational activities such as event planning, basic fundraising processes, risk management planning, website design, accounting and payroll, and contracts and grants regulations and guidelines.
Interpersonal skills including verbal and written communication, active listening, critical thinking, persuasiveness, advising and counseling skills. To include decision making and problem solving skills for a complex surgical department and for customers at all levels including physicians and staff.
Strong skills in short-term planning, analysis, problem-solving, and customer service. With the ability to track trends and make recommendations based on those results.
Thorough knowledge of University rules and regulations, processes, protocols and procedures for budget, accounting and fund management, and / or personnel management.
Solid knowledge of common University-specific computer application programs. With proven experience and working know of epic, billing software and spreadsheet programs such as excel.
Ability to use discretion and maintain confidentiality.
Proficient knowledge of claims requirements for all insurance carriers. This is to include billing, documentation and follow-up criteria inclusive of appeals process.
Experience creating budgets and tracking productivity and other clinical billing metrics with the ability to analyze results and recommend solution.
Ability to set and follow through with goals and work independently with minimum direction.
Master's degree in related area and/or (five) 5 years equivalent experience/training
Certified coder with excellent knowledge of CPT coding, ICD-10 diagnostic codes and medical terminology for Orthopaedic Surgery.
Must be willing and able to travel.
Occasional evenings and weekends may be required.
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.
UC San Diego Health Sciences is comprised of our School of Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, The Herbert Wertheim School of Public Health and Human Longevity Science, and our Student Health and Well-Being Department. We have long been at the forefront of translational - or "bench-to-bedside" - research, transforming patient care through discovery and innovation leading to new drugs and technologies. Translational research is carried out every day in the hundreds of clinical trials of promising new therapies offered through UC San Diego Health, and in the drive of our researchers and clinician-scientists who are committed to having a significant impact on patient care. We invite you to join our team!
Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.
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UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html
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