Job details
Job type full-time
Full job description
Department description
The revenue integrity & health information management enterprise services (rihimes) team strives to achieve the highest customer satisfaction level by providing a well-documented, accurate, timely medical care record for continuing patient care, research, teaching, reimbursement, and community serviceIts primary purpose is to serve our patients by facilitating treatment, research, reimbursement, and education based on a well-documented medical recordRevenue integrity (ri) program and services at ucd implements methodology to efficiently manage revenue and align staff, projects, process, and technology to accurately assure optimal reimbursement for clinical services rendered at university of california, davis health.
Job summary final filing date 11/6/2021
Salary range $6,608.33 - $14,808.33
Salary frequency monthly
Appointment type career
Number of positions 1
Percentage of time 100%
Shift hour 8 hours
Location remote work available, armstrong bldg
City mather, ca
Union representation no
Benefits eligible yes
We offer exceptional employment benefits including medical, dental, and vision plans, generous paid vacations and holidays, excellent retirement savings and investment plans, continuing education, and reduced fee and scholarship programsThis is not an h1- b opportunity responsibilities the revenue integrity enterprise monitoring analyst will be responsible for interpreting and monitoring enterprise-wide revenue by service lineThe individual will serve as a subject matter expert for hospital and professional health system revenue cycle activities with impact on net revenueExpert knowledge of healthcare revenue cycle functions and how they impact net revenueEvaluate issues and data sets related to anomalies in revenue and possible bottlenecks related to reimbursementBe able to understand impact on net revenue from front line registration functions, physician documentation, coding, billing to reimbursementBe able to measure compliance with charge lag, backlogs, timeliness and etcIn addition, this individual will serve as liaison and as subject matter expert for other revenue integrity function and work with other revenue cycle managers and staff as well as other 3rd party applications that are used in the revenue cycleThis individual will work with department leaders, administrators, cross-functional work groups, information technology project management, and outside 3rd party application technical experts and consulting services to ensure optimization, revenue integrity, and maximization of reimbursementThe monitoring function identifies issues and escalates to leadership in a timely manner thus enabling ‘call to action’ risk mitigation/remedies activities to defend and protect revenue for hospital, facility, and professional feesThis position is also responsible for providing some level of system process support, problem resolution, project management, analytical, research, and statistical data to the billing process in revenue integrity and contract managementResponsible for aiding in maintaining systems, processes, and workflows for the timely and accurate recording of hospital/professional revenue regarding charge captureData scientist and a revenue cycle technical leader with a high degree of knowledge in specific areas; problem-solving frequently requires analysis of unique issues/problems without precedentWorks with internal and external departments to formulate revenue mitigation strategiesInvolves cross-functional areas in assessments related to revenue cycle including system billing, reporting team, patient access, registration, insurance verification, authorizations, charge capture, coding, data entry, billing, and contract managementProvides expert analysis and reporting of revenue performance; acts as a department liaison for revenue integrity enterprise monitoring; identifies, tracks and bring to resolution to revenue-related issues in partnership with other revenue integrity experts, revenue cycle leads, patient access, and business officeThe primary functions of this position are data analysis, process improvement/development, problem resolution, and workflow and revenue monitoring oversightThis position requires an expert level of healthcare operations and contract knowledge, a high level of independence and creativity, advanced analytical skills and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems in revenue cycle program areas, to identify weaknesses and develop innovative solutions and process improvements, sound judgment, as well as organizational and priority setting abilities.
Required qualifications applicants are encouraged to upload license and certification if required of the position.
Bachelor`s degree in health care information technology, computer science, or related area, and/or equivalent combination of experience/training.
Billing and accounts receivable analysis/management experience.
Experience working with revenue cycle information systems or system implementation teams for complex projects, application development, and support.
Experience working with healthcare information systems.
Technical knowledge of all licensed health care service plans, including state and federal plans, billing policies and procedures, and the ability to recognize when they are not being followed.
Knowledge of hospital billing and reimbursement procedures for commercial/managed care and government payers and the ability to recognize when policies are not being followed (including experience with contracts pertaining to the division of financial responsibility and evaluating billing and reimbursement terms).
Expert knowledge of and demonstrated skill with various spreadsheet and software applications, including microsoft excel and word, clearinghouse, contract management, and patient accounting systems.
In-depth knowledge of the healthcare revenue cycle`s practices, procedures, and concepts and its component operations, including billing, collections, charge capture, contractual terms, third-party reimbursements, and cash management.
Knowledge of significant healthcare trends and issues that affect physicians, hospitals, and academic health centers.
Knowledge of health system methods, policies, and procedures.
In-depth understanding of the issues, processes, reporting instruments, metrics, dashboard design, and other tools and techniques involved with measuring and analyzing the revenue cycle.
Knowledge and skill in working with committees and user groups to facilitate group decision-making.
Advanced organizational and project management skills and ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule.
Advanced communications skills to interpret and convey complex clinical finance information in a clear, concise manner.
Advanced skills in report development and various software tools specific to healthcare revenue cycle management.
Skills in a common database, spreadsheet, and presentation software.
Advanced interpersonal skills, with the ability to collaborate effectively on highly complex projects in a team environment with various business and clinical areas.
Writing skills to compose correspondence to parties outside the department and sufficiently communicate to other units within the department.
Math skills to accurately add, subtract, multiply and divide.
Reading skills to understand department policy and to read correspondence from within and outside the business office.
Typing skills sufficient to operate computer terminal, prepare correspondence for both within and outside the department.
Strong ability to advise management, serving as a technical expert, providing proposals for improvement and guidance on regulatory changes and industry trends and developments in revenue cycle management.
Ability to interpret a large volume of data and report it in a concise, meaningful manner.
Ability to prepare compelling and informative reports and presentations to all levels of staff and management.
Ability to work accurately and quickly under pressure to meet deadlines set by the department, government programs, or private insurance carriers.
Ability to review the work product of departmental employees and report findings.
Ability to react with flexibility and patience and maintain efficiency and accuracy under sustained and immediate pressure created by a heavy workload, frequent interruptions, and multiple, sometimes competing requests.
Ability to work cooperatively and constructively with employees and administration.
Ability to develop evaluation criteria for improving departmental activities/programs.
Ability to develop reports or correspondence as required.
Ability to use billing codes, including cpt, hcpcs, revenue codes, and icd-10.
Develops and implements changes to systems, policies, and procedures to maintain currency in government regulations, reimbursement issues, and other matters having a potential financial impact.
Demonstrates professionalism, tact, courtesy, and diplomacy in dealing with personnel at all levels outside the health system.
Preferred qualifications
Academic institution or large integrated health system experience.
Experience working with clinical information systems or system implementation teams for complex projects and application development.
Advanced organizational and project management skills and ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule.
Experience working with interfaced/integrated multi-vendor applications.
Knowledge and understanding of university policies and proceduresExtensive knowledge of cms federal and state provider enrollment processes.
Special requirements
Must be able to work occasional overtime and/or flexible hours as needed
This position may be subject to a criminal background investigation, drug screen, live scan fingerprinting, medical evaluation clearance, and functional capacity assessment.
The university of california has implemented a sars-cov-2 (covid-19) vaccination program sars-cov-2 vaccination policy (ucop.edu) covering all employeesTo be compliant with the policy, employees must submit proof of vaccination or a university-approved exception or deferral.
Eeo the university of california is an equal opportunity/affirmative action employer advancing inclusive excellenceAll 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.
