UCSD Layoff from Career Appointment: Apply by 06/01/2017 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.
Under minimal supervision, manage and conduct research and detailed billing analytical reviews to determine the accuracy of medical billing claims by evaluating billing reports for compliance with CPT, HCPCS, ICD-10 codes, research billing modifiers, Hospital DRG, CMS1500 and UB-04 claim forms. Evaluate charge posting accuracy to determine compliance with UCSD clinical research billing policy utilizing the study coverage analysis for both hospital facility charges and professional fee billing. Independently analyze and communicate a strong knowledge of general human subject research principles, federal research regulations, state laws related to coding and reimbursement rules, including those specific to research billing. Analyze and evaluate the accuracy of the billing process and conduct strategic risk assessment in order to ensure compliance. Respond to and comply with audit requests using complex problem solving techniques. Participate in developing and implementing policies and procedures and other monitoring tools in order to facilitate and enhance accurate claim submission. Work with UCSD Finance and IT departments to determine if there are issues or concerns with the current research billing tools set up in the Electronic Medical Record billing systems related to research billing requirements.
Must have a current CPC certification or to begin training to obtain CPC-A certification within the first year of employment.
Graduation from college with a major in business administration, biological science, statistics, educational administration; or an equivalent combination of education and experience.
Four (4) years of direct experience in auditing research claims, administrative analysis or research operations.
Demonstrated in-depth knowledge and ability to conduct comprehensive and detailed audit of patient research and billing records for appropriate medical record documentation.
Recent experience working in an academic medical center or healthcare environment, with knowledge and experience working with CPT/HCPCS coding.
Strong understanding of both hospital technical fee and professional fee billing.
Recent experience working with an electronic medical record and billing system.
Medical terminology, anatomy and physiology courses.
Knowledge of research procedures, general billing regulations including billing for research clinical trials, applicable state laws, site practices and University policies regarding research/clinical trials.
Excellent, fast and accurate computer skills using Microsoft Office applications (Excel, Word, PowerPoint).
Ability to quickly learn other software applications as assigned.
Medical billing and coding of all specialties.
Knowledge of research billing requirements.
Knowledge of Clinical Trial Management Systems.
Proficiency in medical computer information systems and various software packages.
Knowledge and experience reviewing professional fee and hospital (facility) codes and claims.
Proficiency in UCSD Health and UCSD Medical Group computer information systems and other various software packages.
Must be willing to work various hours and locations based on business needs.
UC San Diego is an academic powerhouse and economic engine, recognized as one of the top 8 public universities by U.S. News and World Report. Innovation is central to who we are and what we do. Here, students learn that knowledge isn't just acquired in the classroom - life is their laboratory. UC San Diego's rich academic portfolio includes six undergraduate colleges, five academic divisions and ...five graduate and professional schools. The university's award-winning scholars are experts at the forefront of their fields with an impressive track record for achieving scientific, medical and technological breakthroughs.