Revenue Integrity Specialist - Remote - 117893
As a federally-funded institution, UC San Diego Health maintains a marijuana and drug free campus. New employees are subject to drug screening.
#117893 Revenue Integrity Specialist - RemoteExtended Deadline: Fri 10/7/2022
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 08/04/22 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 08/09/22. Eligible Special Selection clients should contact their Disability Counselor for assistance.
Candidates hired into this position will be able to work remotely.
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.
The Revenue Integrity Specialist (RIS) is a Revenue Integrity team member responsible for ensuring charges have been captured correctly to facilitate timely billing and appropriate reimbursement. The RIS will effectively resolve charge errors by collaborating with Coding, Patient Financial Services, IS, and other Revenue Cycle Staff stakeholders as necessary. The RIS will focus on timely completion of edits that are holding up billing and follow established policies, timeframes, government regulations, and payer requirements. The RIS will coordinate with Charge Review Specialist (CRS) to determine appropriate solutions to trended charge and claim edit issues, assist in root-cause solutions and advise service line leaders and staff on proper usage of charge codes when necessary.
- Resolves charge edit issues identified by working through assigned WQs
- Ensures timely capture of charges via WQ and edit optimization
- Determine charge issues/trends based on common issues found in WQs and Reports
- Coordinate with other RC staff to determine root cause of issues and outline suggested recommendations for resolution
- Identify new charge edits based upon root cause analysis of charging denials
- Creates education tools and resources for staff to ensure that proper usage of charge codes is occurring across UCSD
- Maintains overall financial understanding of the Revenue Integrity department through collaboration and effective communication with physicians as well as coding, billing, clinical departments, and other charge entry staff.
Active certification as a RHIA, RHIT, or CCS, CCS-P from AHIMA or CPC, COC from AAPC.
Seven (7) years of related experience, education/training of directly related healthcare revenue cycle experience, OR a Bachelor’s degree in related area plus three (3) years of related experience/training of directly related healthcare revenue cycle 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.
Previous Hospital Billing and Coding experience.
EPIC user experience.
Must be able to work various hours and locations based on 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).
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 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, the only Burn Center in the county, and and dozens of outpatient clinics. 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.
To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.
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
UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.
Job Reference #: 117893