University of California Davis Health System
Clinical Document Specialist 3
University of California Davis Health System, Sacramento, California, United States, 95828
Clinical Document Specialist 3
Job Summary
The role of this position is to serve as an auditor in the Revenue & Insurance Audit Unit within the Patient Financial Services Department. The auditor does retrospective reviews and analyses of patient medical records in comparison to the patient final bill. The data collected is used to ensure clean bills as per contract requirements, re-bill for charge corrections and to negotiate settlement with third party payers.
Apply By Date
9/20/2024 at 11:59pm
Minimum Qualifications
Bachelor's degree in nursing or related area, and/or equivalent combination of experience/training required.Experience reading/abstracting electronic medical record documents and interpreting the clinical information.Experience with the clinical and operational issues involved with inpatient care, including the diagnoses, treatments, medical procedures, complications, co-morbidities, discharge, and other practices that are part of effective clinical care systems.College level understanding of disease processes, anatomy and physiology necessary to interpret critical lab values, medical necessity of diagnostic and therapeutic procedures, and the administration of medications.Knowledge of and understanding of multi-medical specialties, and procedures in acute and critical setting.Ability to read/abstract electronic medical record documents and interpret the clinical information.Comprehensive knowledge of medical diagnostic and procedural terminology required.Proficient in Microsoft Word and Excel.Ability to perform mathematical computations and statistical analysis to support billed charges, including billed pharmacy charges.Computer skills to input and extract information from billing system.Ability to read and comprehend English text and medical terminology: knowledge of medical and nursing treatment plans, levels of care associated with acute and critical care.Skills to perform in-depth chart analysis to provide accurate information in a concise, informative manner, identify/analyze problems or issues related to areas of responsibility.Ability to communicate and work with varied health care team professionals in a manner that establishes a good rapport and professional working relationship.Ability to work efficiently and independently, maintaining a calm manner while under pressure.Ability to organize work to accommodate special projects, deadlines and priorities; ability to be both flexible and adaptable in order to coordinate multiple variables and to respond to the need of a multi-faceted work area.Understands the need to utilize discretion and maintain confidentiality when discussing patient matters.Successfully applies interpersonal communication skills in areas such as conflict management.Ability to be flexible and adaptable in order to accommodate the needs of a multifaceted work area.Demonstrates leadership skills sufficient to direct others toward accomplishing goals in a positive manner that are conducive to overall positive operations within the department.Verbal and written communication skills to clearly and concisely receive, elicit and convey information regarding documentation issues with the medical staff and other health care providers.Written communication skills to clearly and concisely compose letters, reports, policies and procedures that may include medical, financial and administrative information.Ability to exercise judgment with minimal supervision.Ability to be flexible, adaptable and follow many different guidelines which change frequently.Ability to handle the stress and pressures of a job where there is noise from conversation and other interruptions.Ability to read text for a long period of time from a book, medical record and/or computer terminal.Must be able to work occasional overtime.
Preferred QualificationsCurrent California RN license preferred.3+ years experience in a similar Nurse Auditor role.1+ year experience working in EPIC Resolute - HB.
Key Responsibilities75% - Internal Audits.10% - Transfer Requests, Medicare ADR's, Follow-up, Legal.5% - Observation Case Review.5% - Organ Donor Pre-Bill Review.5% - External (Defense) Audits.
Department OverviewPatient Financial Services (PFS) manages revenue cycle functions including DNFB, billing, contract management, insurance follow-up, charge audit, denials, underpayments as well as internal operational and functional reporting and support related to hospital/facility billing. PFS ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services rendered. PFS impacts processes to include charge capture, coding, insurance identification, data/charge entry, registration, authorizations, billing, payment posting, refund processing and collections.
POSITION INFORMATIONSalary or Pay Range: $
3,524.90
- $
6,590.03Salary Frequency:
BiweeklySalary Grade: Grade 24UC Job Title: CLIN DOC SPEC 3Number of Positions:
1Appointment Type: Staff: CareerPercentage of Time: 100Shift Hours: 8am to 4:30pm
, 8 hourLocation: UCDHAS Building (HSP165)Union Representation: 99 - Non-Represented (PPSM)Benefits Eligible:
YesHybrid/Remote/Onsite: This position is hybrid (mix of on-site and remote work)
BenefitsOutstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy
Benefits Summary for UC Davis Health Employees
or
Benefits Summary for UC Davis Employees
and our
Benefits Page .
Physical DemandsSitting - Continuous 6 to 8+ HoursKeyboard use/repetitive motion - Continuous 6 to 8+ Hours
Environmental DemandsLoud noise levels - Occasional Up to 3 Hours
Mental DemandsSustained attention and concentration - Continuous 6 to 8+ HoursComplex problem solving/reasoning - Continuous 6 to 8+ HoursAbility to organize & prioritize - Continuous 6 to 8+ HoursCommunication skills - Continuous 6 to 8+ HoursNumerical skills - Continuous 6 to 8+ HoursConstant Interaction - Occasional Up to 3 HoursCustomer/Patient Contact - Occasional Up to 3 HoursMultiple Concurrent Tasks - Continuous 6 to 8+ Hours
Work EnvironmentMust be able to work occasional overtime and flexible hours as needed for projects. These positions are subject to a criminal background investigation. See Skills, Knowledge and Abilities for additional information.
Special RequirementsThis is a critical position, as defined by UC policy and local procedures, and as such, employment is contingent upon successful completion of background check(s), including but not limited to criminal record history background check(s).This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements.
Diversity, Equity, Inclusion and BelongingAt UC Davis, we're solving life's most urgent challenges to bring a fuller, healthier, and more resilient world within reach. We grow from every challenge we take on and we don't just maintain - we improve. We recognize that creating an inclusive and intellectually vibrant organization means understanding and valuing both our individual differences and our common ground. The most comprehensive solutions come from the most diverse minds and you belong here. As you consider joining UC Davis, please explore our
Principles of Community , our
Clinical Strategic Plan
and
strategic vision
for research and education, and our latest efforts to
outgrow the expected . The University of California, Davis is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.
To apply, visit
https://careerspub.universityofcalifornia.edu/psc/ucdmed/EMPLOYEE/HRMS/c/HRS_HRAM_FL.HRS_CG_SEARCH_FL.GBL?Page=HRS_APP_JBPST_FL&JobOpeningId=72671&PostingSeq=1&SiteId=5&languageCd=ENG&FOCUS=Applicant
The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 nondiscrimination policy.#J-18808-Ljbffr
Job Summary
The role of this position is to serve as an auditor in the Revenue & Insurance Audit Unit within the Patient Financial Services Department. The auditor does retrospective reviews and analyses of patient medical records in comparison to the patient final bill. The data collected is used to ensure clean bills as per contract requirements, re-bill for charge corrections and to negotiate settlement with third party payers.
Apply By Date
9/20/2024 at 11:59pm
Minimum Qualifications
Bachelor's degree in nursing or related area, and/or equivalent combination of experience/training required.Experience reading/abstracting electronic medical record documents and interpreting the clinical information.Experience with the clinical and operational issues involved with inpatient care, including the diagnoses, treatments, medical procedures, complications, co-morbidities, discharge, and other practices that are part of effective clinical care systems.College level understanding of disease processes, anatomy and physiology necessary to interpret critical lab values, medical necessity of diagnostic and therapeutic procedures, and the administration of medications.Knowledge of and understanding of multi-medical specialties, and procedures in acute and critical setting.Ability to read/abstract electronic medical record documents and interpret the clinical information.Comprehensive knowledge of medical diagnostic and procedural terminology required.Proficient in Microsoft Word and Excel.Ability to perform mathematical computations and statistical analysis to support billed charges, including billed pharmacy charges.Computer skills to input and extract information from billing system.Ability to read and comprehend English text and medical terminology: knowledge of medical and nursing treatment plans, levels of care associated with acute and critical care.Skills to perform in-depth chart analysis to provide accurate information in a concise, informative manner, identify/analyze problems or issues related to areas of responsibility.Ability to communicate and work with varied health care team professionals in a manner that establishes a good rapport and professional working relationship.Ability to work efficiently and independently, maintaining a calm manner while under pressure.Ability to organize work to accommodate special projects, deadlines and priorities; ability to be both flexible and adaptable in order to coordinate multiple variables and to respond to the need of a multi-faceted work area.Understands the need to utilize discretion and maintain confidentiality when discussing patient matters.Successfully applies interpersonal communication skills in areas such as conflict management.Ability to be flexible and adaptable in order to accommodate the needs of a multifaceted work area.Demonstrates leadership skills sufficient to direct others toward accomplishing goals in a positive manner that are conducive to overall positive operations within the department.Verbal and written communication skills to clearly and concisely receive, elicit and convey information regarding documentation issues with the medical staff and other health care providers.Written communication skills to clearly and concisely compose letters, reports, policies and procedures that may include medical, financial and administrative information.Ability to exercise judgment with minimal supervision.Ability to be flexible, adaptable and follow many different guidelines which change frequently.Ability to handle the stress and pressures of a job where there is noise from conversation and other interruptions.Ability to read text for a long period of time from a book, medical record and/or computer terminal.Must be able to work occasional overtime.
Preferred QualificationsCurrent California RN license preferred.3+ years experience in a similar Nurse Auditor role.1+ year experience working in EPIC Resolute - HB.
Key Responsibilities75% - Internal Audits.10% - Transfer Requests, Medicare ADR's, Follow-up, Legal.5% - Observation Case Review.5% - Organ Donor Pre-Bill Review.5% - External (Defense) Audits.
Department OverviewPatient Financial Services (PFS) manages revenue cycle functions including DNFB, billing, contract management, insurance follow-up, charge audit, denials, underpayments as well as internal operational and functional reporting and support related to hospital/facility billing. PFS ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services rendered. PFS impacts processes to include charge capture, coding, insurance identification, data/charge entry, registration, authorizations, billing, payment posting, refund processing and collections.
POSITION INFORMATIONSalary or Pay Range: $
3,524.90
- $
6,590.03Salary Frequency:
BiweeklySalary Grade: Grade 24UC Job Title: CLIN DOC SPEC 3Number of Positions:
1Appointment Type: Staff: CareerPercentage of Time: 100Shift Hours: 8am to 4:30pm
, 8 hourLocation: UCDHAS Building (HSP165)Union Representation: 99 - Non-Represented (PPSM)Benefits Eligible:
YesHybrid/Remote/Onsite: This position is hybrid (mix of on-site and remote work)
BenefitsOutstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy
Benefits Summary for UC Davis Health Employees
or
Benefits Summary for UC Davis Employees
and our
Benefits Page .
Physical DemandsSitting - Continuous 6 to 8+ HoursKeyboard use/repetitive motion - Continuous 6 to 8+ Hours
Environmental DemandsLoud noise levels - Occasional Up to 3 Hours
Mental DemandsSustained attention and concentration - Continuous 6 to 8+ HoursComplex problem solving/reasoning - Continuous 6 to 8+ HoursAbility to organize & prioritize - Continuous 6 to 8+ HoursCommunication skills - Continuous 6 to 8+ HoursNumerical skills - Continuous 6 to 8+ HoursConstant Interaction - Occasional Up to 3 HoursCustomer/Patient Contact - Occasional Up to 3 HoursMultiple Concurrent Tasks - Continuous 6 to 8+ Hours
Work EnvironmentMust be able to work occasional overtime and flexible hours as needed for projects. These positions are subject to a criminal background investigation. See Skills, Knowledge and Abilities for additional information.
Special RequirementsThis is a critical position, as defined by UC policy and local procedures, and as such, employment is contingent upon successful completion of background check(s), including but not limited to criminal record history background check(s).This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements.
Diversity, Equity, Inclusion and BelongingAt UC Davis, we're solving life's most urgent challenges to bring a fuller, healthier, and more resilient world within reach. We grow from every challenge we take on and we don't just maintain - we improve. We recognize that creating an inclusive and intellectually vibrant organization means understanding and valuing both our individual differences and our common ground. The most comprehensive solutions come from the most diverse minds and you belong here. As you consider joining UC Davis, please explore our
Principles of Community , our
Clinical Strategic Plan
and
strategic vision
for research and education, and our latest efforts to
outgrow the expected . The University of California, Davis is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.
To apply, visit
https://careerspub.universityofcalifornia.edu/psc/ucdmed/EMPLOYEE/HRMS/c/HRS_HRAM_FL.HRS_CG_SEARCH_FL.GBL?Page=HRS_APP_JBPST_FL&JobOpeningId=72671&PostingSeq=1&SiteId=5&languageCd=ENG&FOCUS=Applicant
The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 nondiscrimination policy.#J-18808-Ljbffr