Reimbursement HC Analyst 4 -Patient Financial Services - FT Days - 19479-1A

Employer
University of California-Irvine
Location
Orange
Closing date
Sep 9, 2021

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Administrative Jobs
Institutional & Business Affairs, Business & Financial Management

Job Details

Updated: Jun 10, 2021
Location: Orange
Job Type:
Department: Patient Financial Services

Job Description:

UC Title:

REIMB HC ANL 4

Reports to:

Reimbursement HC Supervisor 2

Cost Center:

Patient Financial Services (428550)

FLSA:

Exempt

Job Code:

006768

Shift:

Not Applicable

Position Number:

40308790

Working Title:

Reimbursement HC Analyst 4

Bargaining Unit:

No Bargaining Unit

Date Created:

6/04/2021

Hours:

40

FTE:

1

Position Summary:

The incumbent is responsible to perform review of denied claims, conducting medical records reviews with use of standardized medical review software, determining claim appealability and initiates formal written or verbal appeals with various health plans. Must have knowledge of medical terminology, various health plan products (Medicare, Medi-Cal, HMO, PPO, Managed Care, etc.) private insurance and CMS guidelines. Previous experience substantiating appeals for Trauma, Acute and Psychiatric services. Also responsible for conducting external charge defense audits requested by insurance companies in collaborating with various audit firms for the conclusion of audits. Performs additional related duties, as assigned.

Salary Range:

Minimum

Midpoint

Maximum

Annual Rate

$69900

$106400

$143000

Required Qualifications:

  • Ability to establish and maintain effective working relationships across the Health System
  • Ability to maintain a work pace appropriate to the workload
  • Must demonstrate customer service skills appropriate to the job
  • Excellent written and verbal communication skills in English
  • Competent knowledge and experience with Microsoft Office computer applications, i.e. Word, Excel
  • Three years’ experience working in clinical denial review and/or clinical appeal processing
  • Three years of related clinical experience in an acute care setting
  • Five years of internal and/or external audit experience
  • Familiarity of audit software packages
  • Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
  • Must possess a current California RN license
  • Knowledge of Interqual

Preferred Qualifications:

  • Knowledge of University and medical center organizations, policies, procedures and forms

Organization

Founded in 1965, UC Irvine combines the strengths of a major research university with the bounty of an incomparable Southern California location. Over five remarkable decades, UCI has become internationally recognized for efforts that are improving lives through research and discovery, fostering excellence in scholarship and teaching, and engaging and enriching the community.UC student center

With more than 33,000 students, 1,200 faculty members and 10,000 staff, UCI is among the fastest-growing campuses in the University of California system. Increasingly a first-choice campus for students, UCI ranks among the top U.S. universities in the number of undergraduate applications and continues to admit freshmen with highly competitive academic profiles. Orange County’s second-largest employer, UCI generates an annual economic impact on the county of $5 billion.

UCI is a center for quality education that honors classic instruction while incorporating the best new scholarship. U.S. News & World Report consistently ranks UCI among the nation’s best universities. Achievements in the sciences, social sciences, social ecology, arts, humanities, medicine and business also have garnered numerous national rankings for UCI’s schools, departments and programs. Three UCI researchers have won Nobel Prizes – most recently Irwin Rose, in chemistry, in 2004.

Interdisciplinary research, a UCI hallmark, is evident in the California Institute for Telecommunications and Information Technology, or Calit2, Newkirk Center for Science and Society, Center for the Study of Democracy, Institute of Transportation Studies, Institute for Genomics and Bioinformatics, and innovative instructional programs in biomedical engineering, international studies, global cultures, arts and technology, and other collaborations.

The university is dedicated to excellence through diversity and to the goal of reflecting equity and inclusion in our faculty, staff and student populations. Faculty and staff diversity affinity groups foster cross-departmental social interaction, professional networking, cultural competencies, recruiting and mentoring.

Committed to the Community

UCI reaches beyond the classroom and laboratory to help solve societal issues and support human development. In the health sciences, UCI is noted for its research on cancer, the neurosciences and the genetic underpinnings of disease. UCI Medical Center, Orange County’s only university hospital and Level I trauma center, has been ranked among the nation’s best hospitals by U.S. News & World Report for 16 consecutive years.

UC Irvine parkA major intellectual and cultural center, UCI engages the community through public activities and events. Speakers on campus, for example, have included Nobel Peace Prize winners His Holiness the XIV Dalai Lama, former Soviet leader Mikhail Gorbachev and Iranian human rights activist Shirin Ebadi, all of whom also received the UCI Citizen Peacebuilding Award for their efforts toward world peace.

The university is also addressing the needs of the community and growing world population in an environmentally sustainable way. From the development of new and reliable processes for electricity and alternative fuels to critical water and waste management solutions, UCI consistently tops the list in Sierra magazine’s “Coolest Schools” report, its annual sustainability ranking of U.S. colleges and universities.  

A hub for innovation and entrepreneurship, the university collaborates with the community on many strategic partnerships such as UCI Applied Innovation , a center which brings campus-based discoveries together with Orange County’s vibrant business sector to support job creation and economic growth. Development also continues on the 185-acre University Research Park adjacent to campus, where R&D companies enjoy collaborative opportunities in medical research, biotechnology, engineering, computer science and business.

UCI is benefiting the community and the world in countless ways through its scholarly, scientific, creative and economic contributions. On its way to becoming a flagship UC campus and one of the nation’s very best universities, UCI has embarked on a strategic plan that will ensure the campus continues to inspire excellence as it fulfills its research, teaching and public service missions in the decades ahead.

Find Us
Website:
Telephone
949-824-5011
Location
University of California, Irvine
Irvine
CA
92697
US

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