HB Second Level Reviewer - Remote - 125986

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 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. Represents 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.

• Seven (7) years of related auditing experience i.e. auditing experience in large academic hospital system, education/training, OR a Bachelor's Degree in related area plus three (3) years auditing experience i.e. auditing experience in large academic hospital system, education/training.

• 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.

• Current Credentials as RHIT or RHIA, or CCS, 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.
• Minimum of three (3) years Inpatient and/or Outpatient Facility auditing experience of coders.
• Experience working for Level I Trauma & Academic/Research Facility is a plus.
• 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.