UCSD Layoff from Career Appointment: Apply by 01/19/2023 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 01/31/2023. Eligible Special Selection clients should contact their Disability Counselor for assistance.
Placement within the salary range is determined by internal equity, relevant qualifications, and collective bargaining agreements (when applicable).
This position will work a hybrid schedule which includes a combination of working both onsite at La Jolla and remote.
DESCRIPTION
The Department of Orthopaedic Surgery at UC San Diego School of Medicine is a diverse patient, research, education, and academia focused, high-performing Department with a commitment to quality, collaboration, innovation, and continuous improvement. Orthopaedic Surgery provides treatment for disorders of the musculoskeletal system, offering comprehensive and innovative services. The Department offers a full spectrum of musculoskeletal clinical care, specializing in foot and ankle, hand and microvascular surgery, joint reconstruction, physical medicine and rehabilitation, spine, sports medicine, orthopaedic oncology, and trauma. Research expertise includes advancements in muscle metabolism and physiology, neuromuscular bioengineering, intervertebral disc, and musculoskeletal physiology and epidemiology. The Department supports an ACGME accredited residency program and fellowship in hand and microvascular surgery, as well as fellowship programs in joint reconstruction, spine, and trauma.
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 reviews abstracted provider education to audit ICD-10 and CPT codes for E&M, injections, surgeries, and other services provided by the Department.
The coder is responsible to accurately interpret notes/diagnoses and to convert them into CPT/HCPC/ICD10 codes as appropriate in order to fully capture all billable services. Position to keep up to date and current CPT, and individual insurance company guidelines, as well as orthopedic coding guidelines, and examines claims for accuracy and compliance per all billing and coding guidelines.
Clinical Revenue Analyst to educate and train providers and clinical staff on guidelines and clinical documentation requirements, annually or as needed. Serves as a liaison on behalf of the Department with the Physician Group and Health System to mitigate queries and resolve billing issues and/or delays. Assesses bill areas and funds flow for accuracy. Facilities charge capture, monthly and/or quarterly case review with providers, and 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 and productivity reporting 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.
MINIMUM QUALIFICATIONS
Seven (7) years of related experience, education/training, OR a Bachelor's degree in related area plus three (3) years of related experience/training
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
Strong skills in CPT, ICD-10 and HCPC coding applications
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.
Effective interpersonal skills including verbal and written communication, active listening, critical thinking, persuasiveness, advising and counseling skills. To include decision making an
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