This job is part of the Internal Promotion Program.  Internal candidates must apply for this job by 09/18/09 to have priority consideration.  For more information on the Internal Recruitment Program visit www.ucsdmedicalcenterjobs.com.  

Location:  Hillcrest

Department:  Compliance – Shared Corporate Office

Payroll Title:  Administrative Analyst

Filing Deadline:  09/25/09

Extended Deadline: 11/30/09
Salary commensurate with experience

One full-time (100%) position with benefits starting on the date of hire.

The Compliance Chart Review Specialist:

• Conducts detailed analytical reviews of all types of medical record documentation including billing reports, coding accuracy using CPT, HCPCS, ICD-9, modifiers, DRG and APC coding systems, CMS1500 and UB92 claims forms and posting accuracy to determine compliance with UCSD documentation standards and third party payer requirements for both Hospital and Professional Fee activities.
• Assists in the implementation of the UCSD Health Sciences Corporate Compliance Program which ensures compliance with all federal, state, and private billing requirements.
• Is responsible for analyzing and evaluating the accuracy of the billing process and recommends strategies to ensure accurate coding and appropriate documentation.
• Initiates, responds to, and assists with audit request.
• Assists the Compliance Officer in developing policies and procedures to enhance compliance.
• Assists the Compliance Education Manager with ongoing departmental and individual education sessions to improve CPT4 and ICD-9 coding accuracy and adherence to compliance standards.
• Communicates UCSD documentation and coding standards to all healthcare employees and external billing staff by performing detailed chart reviews, identifying trends, responding to help line questions for coding using in-house resources as well as performing internet searches for information on assigned topics.
• Will assist in Compliance training as needed.

The Compliance Chart Review Specialist must:

• Have demonstrated in-depth knowledge and ability to comprehensively review patient records for appropriate medical record documentation of CPT & ICD-9 coding and DRG assignment.
• Hold current certification as a Professional Coder (CPC, CCS, CCS-P) from a nationally recognized program (i.e. AHIMA, AAPC).
• Have strong Microsoft Office skills.
• Have a strong understanding of medical terminology, medical billing, and coding of all specialties.
• Be able to work various hours and locations based on business needs.
• Have excellent communication skills with the ability to communicate clearly both verbally and in writing and be able to articulate complex ideas for all levels of audiences.
• Be a self-starter who is accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization.
• Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountability.

Preferred:

• Experience in a large, complex healthcare system.
• Proficiency in UCSDMC (PCIS) and UCSD Medical Group (IDX) computer systems.
• Knowledge of teaching physician rules.