Sr. Professional Fee Coder - Analyst III (full-time)

Under the general direction of the Revenue Manager/Associate Director, this position is expected to function as a senior coder with a high degree of accuracy, proficiency, and production in the areas and specialties covered by the Faculty Practice Revenue Management Operations coding team. Applies specialized coding knowledge to manage a large range of coding combinations (approximately 1500 - 5000 combinations). Breadth of understanding of application of moderate to complex coding, coding modifiers, and correct coding initiative guidelines to autonomously manage extensive ICD-10 and CPT procedural codes. May include both professional fee and technical coding application. Also guides a centralized coding team as a subject matter expert for their area of coding expertise to improve the accuracy and efficiency of professional fee coding by the team.

Primary responsibilities of this position include leadership as the subject matter expert to include presentation of information to the team, auditing and oversite of team member's accuracy and production, ensuring that all current federal, state and local carrier guidelines are being enforced by team members at the time of coding, providing education and training to coding staff and physicians, as well as perform at a high production coding to meet UCSF goals for accuracy and charge lag.

Performs in-depth reviews of physician documentation. Responsible for preparing documentation audits, coding analysis reports, and online presentations to present findings along with recommendations to the physician and/or departments. Determines methods and procedures for new assignments. May also be requested to perform physician self-coding analysis and provide detailed compliance feedback to the organization as well as to physician teams, their internal coding team, and other coding teams within the department.

Under the general direction of the Revenue Manager/Associate Director, this position is expected to function as a senior coder with a high degree of accuracy, proficiency, and production in the areas and specialties covered by the Faculty Practice Revenue Management Operations coding team. Applies specialized coding knowledge to manage a large range of coding combinations (approximately 1500 - 5000 combinations). Breadth of understanding of application of moderate to complex coding, coding modifiers, and correct coding initiative guidelines to autonomously manage extensive ICD-10 and CPT procedural codes. May include both professional fee and technical coding application. Also guides a centralized coding team as a subject matter expert for their area of coding expertise to improve the accuracy and efficiency of professional fee coding by the team.

Primary responsibilities of this position include leadership as the subject matter expert to include presentation of information to the team, auditing and oversite of team member's accuracy and production, ensuring that all current federal, state and local carrier guidelines are being enforced by team members at the time of coding, providing education and training to coding staff and physicians, as well as perform at a high production coding to meet UCSF goals for accuracy and charge lag.

Performs in-depth reviews of physician documentation. Responsible for preparing documentation audits, coding analysis reports, and online presentations to present findings along with recommendations to the physician and/or departments. Determines methods and procedures for new assignments. May also be requested to perform physician self-coding analysis and provide detailed compliance feedback to the organization as well as to physician teams, their internal coding team, and other coding teams within the department.

Required Qualifications:

• Bachelor's degree in a related area and three years of relevant experience, or a HS Diploma / GED with seven years of relevant experience.
• Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or licensure equivalent to be evaluated by FPRMO management.
• Secondary certification in the coding area related to a subject matter department at UCSF Health
• Thorough knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• Thorough understanding of the issues, processes, reporting instruments, metrics, analytics, and other tools and techniques involved with measuring and analyzing the revenue cycle.
• Detail-oriented, with proven ability to effectively manage time, see tasks and projects through to completion, organize competing priorities, and effectively address complex, urgent issues as they arise.
• Strong skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet, and presentation software.
• Strong communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations.
• Strong analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems and propose innovative solutions.
• Strong interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment with staff from a wide variety of business and clinical areas.
• Proven ability to work with managers, serving as a technical resource, providing recommendations and advice on regulatory changes, and industry trends and developments in revenue cycle management.
• Strong analytical and problem-solving skills. An in-depth knowledge of all facets of the billing and revenue cycle process, including a fundamental understanding of coding (CPT and ICD-9) and documentation requirements (for both billing and compliance), the billing submission process, and the accounts receivable management process.
• Knowledge of the federal and state Medicare and Medi-Cal policies and how these programs impact billing and collections.
• The ability to work Monday-Friday, 7:30 a.m. -4:30 p.m., pacific time.

Required Qualifications:

• Bachelor's degree in a related area and three years of relevant experience, or a HS Diploma / GED with seven years of relevant experience.
• Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or licensure equivalent to be evaluated by FPRMO management.
• Secondary certification in the coding area related to a subject matter department at UCSF Health
• Thorough knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• Thorough understanding of the issues, processes, reporting instruments, metrics, analytics, and other tools and techniques involved with measuring and analyzing the revenue cycle.
• Detail-oriented, with proven ability to effectively manage time, see tasks and projects through to completion, organize competing priorities, and effectively address complex, urgent issues as they arise.
• Strong skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet, and presentation software.
• Strong communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations.
• Strong analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems and propose innovative solutions.
• Strong interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment with staff from a wide variety of business and clinical areas.
• Proven ability to work with managers, serving as a technical resource, providing recommendations and advice on regulatory changes, and industry trends and developments in revenue cycle management.
• Strong analytical and problem-solving skills. An in-depth knowledge of all facets of the billing and revenue cycle process, including a fundamental understanding of coding (CPT and ICD-9) and documentation requirements (for both billing and compliance), the billing submission process, and the accounts receivable management process.
• Knowledge of the federal and state Medicare and Medi-Cal policies and how these programs impact billing and collections.
• The ability to work Monday-Friday, 7:30 a.m. -4:30 p.m., pacific time.