Audit Professional - Health Information

Position: Audit Professional 2 - Health Information - FT Days

Audit Professional 2 – Health Information – FT Days

Req

Location:

Orange, CA
Division:
Medical Center
Department:
Health Information
Position Type:
Full Time
Salary Range Minimum: USD $31.47/Hr.
Salary Range Maximum: USD $55.12/Hr.

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 Medical Center is a 459‑bed acute care hospital in Orange, California. The UCI Health Community Network includes four hospitals and affiliated physicians in Orange and Los Angeles counties and ambulatory care centers across the region. UCI Health serves a region of nearly four million people in Orange County, western Riverside County, and southeast Los Angeles County.

Your

Role on the Team Position Summary

The incumbent is responsible for conducting concurrent and retrospective audits of medical records to ensure the presence and timeliness of clinical information as defined by the Medical Staff General Rules and Regulations, Title 22, Medicare’s Conditions of Participation and Joint Commission requirements. The incumbent reviews records for evidence of documentation of medical‑necessity criteria in response to payment denials/chart requests from insurance companies, compiles data of the findings, and prepares reports for the Director for presentation at various committee meetings.

The incumbent analyzes and identifies patterns and trends to identify opportunities for improvement, participates in physician and health‑care provider education to facilitate documentation within the medical record, assists with the coordination of the forms committee to ensure forms content is compliant with outside regulatory requirements, and assists with other medical‑record related functions as required or assigned.

What It Takes to be Successful

Required Qualifications

• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Extensive knowledge of Joint Commission physician documentation requirements, Medicare’s Conditions of Participation, Title 22 documentation requirement and Medicare’s National and Local Coverage Determination Medical Necessity requirements for procedure performance
• Excellent written and verbal communication skills in English
• Demonstrated knowledge of medical terminology
• Demonstrated experience with database information retrieval and analysis
• Demonstrated ability to compare data from a variety of sources and accurately identify variances or discrepancies in the data
• Attention to details with the ability to troubleshoot and pursue problems to satisfactory resolution
• Analytical skills to identify problems, conduct research, analyze data and determine solutions
• Advanced computer skills to include navigation and operation of MS Office products (Word, Excel, PowerPoint, Access), with the ability to run various reports
• Ability to understand and correctly interpret clinical documentation contained in an electronic medical record
• Ability to maintain a work pace appropriate to the workload
• Ability to establish and maintain effective working relationships across the Health System
• 5 years previous experience working with an electronic health record system

Preferred Qualifications

• Working knowledge of EPIC electronic health record
• Knowledge of University and medical center organizations, policies, procedures and forms

Total Rewards

UCI provides a comprehensive benefits package that includes medical insurance, paid sick and vacation time, retirement savings plans, and access to a number of discounts and perks.

Conditions of Employment

All applicants who accept an offer of employment at UCI must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment
• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre‑Placement Health Evaluation

Equal Opportunity Statement

The University of California is an Equal Opportunity 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 Anti‑Discrimination Policy.

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

How to Apply

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