Director, Professional Coding Quality & Education - Finance & Value Transformation

Director, Professional Coding Quality & Education - Finance & Value Transformation

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Req ID : 93591

Location : Orange, California

Division : Medical Center

Department : Finance & Value Transformation

Position Type : Full Time

Salary Range Minimum : USD $85,400.00 / Yr.

Salary Range Maximum : USD $156,800.00 / Yr.

Who We Are

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County.

UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region.

Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal / neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center.

UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.

To learn more about UCI Health, visit www.ucihealth.org.

Your Role on the Team

Position Summary :

Incumbent will manage and oversee others in all professional coding across the UCI Health Professional Enterprise. Directs the planning, development, initiation, and maintenance of a coding training program for billing providers.

This includes identifying nuances between different departments, selecting coding champions, and assessing opportunity areas.

Responsible for maintaining and distributing educational content as it pertains to revenue integrity, keeping abreast of federal and state guidelines and annual updates.

This also includes revenue cycle activities associated with Professional Services, with the goal of accurately reflecting the severity and acuity of cases.

Ensures that all coding is compliant with federal / state and payer-specific coding and billing requirements. Identifies training and education needs of all employees requiring knowledge or instructions on ICD-10 and CPT coding principles and guidelines.

Acts as liaison / coding consultant for all professional coding. Partners with Compliance and Clinical informatics on development and distribution of content.

This position will have a dual reporting structure to Faculty and Clinical Affairs and Revenue Integrity.

What It Takes to be Successful

Required Qualifications :

• Strong knowledge of the ICD-10 Official Coding Guidelines for Coding and Reporting, UHDDS definitions, AMA CPT and Modifier rules, bundling rules and documentation requirements for medical necessity set forth in associated Medicare NCD or LCD's
• Project management and advance software skills
• Possesses broad knowledge of various medical specialties and appreciates the complexities of subspecialty coding practices
• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Knowledge of CMS's HCC hierarchies and risk adjustment models and HEDIS reporting
• In-depth knowledge of professional clinical coding & reimbursement topics and experience with electronic medical records
• Graduation from a formal coder training program or completion of an academic class in medical coding
• Familiarity with compliance query guidelines, denial management and price transparency requirements
• Familiarity to partner with the Revenue Integrity Department to ensure chargemaster maintenance for accurate capture of reimbursement for services and procedures provided in physician practices
• Familiar with Population Health-based metrics, including PQRS, MIPS and VBM merit-based incentive payment systems
• Excellent leadership and fiscal management skills and ability to create a goal-oriented climate of teamwork, collaboration, and consistent achievement of objectives
• EPIC expertise and knowledge, including certifications in revenue cycle as related to EPIC
• Demonstrates advanced written and verbal English communication, interpersonal, organizational, analytical, and presentation skills.
• Demonstrated excellent critical thinking and problem-solving abilities, including the ability to assess and evaluate operations, produce and interpret reports, develop new policies and strategies, and implement plans
• Demonstrated ability to present to large groups / conferences (such as AHIMA)
• Bachelor's degree in Health Information Management or related field and / or equivalent experience / training
• Ability to maintain a work pace appropriate to the workload
• Ability to leverage technology to create greater efficiencies and establish related tracking and audit procedures
• 7 years related work experience with extensive management experience in ICD-10-CM and CPT-4 coding of inpatient and outpatient records in an acute care facility and experience in using a computerized abstracting, encoding, and database systems

Preferred Qualifications :

1-2 years' experience in an Academic medical center

Conditions of Employment :

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment :

• Background Check and Live Scan
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page : https : / / hr.uci.edu / new-hire / conditions-of-employment.php

Closing Statement :

The University of California, Irvine is an Equal Opportunity / Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities.

Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.

edu or at (949) 824-0500, Monday - Friday from 8 : 30 a.m. - 5 : 00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization

To apply, visit https : / / jobs.uci.edu / careers-home / jobs / 93591

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