Branch Review Specialist jobs in Downey, CA

Job Title: Claims Review Specialist

Length of Assignment: 6 months with the strong possibility of extension

Shift: 8:00 am - 5:00 pm -includes a 60 min break (M-F)

Location: Remote

Job Description:

Experience required

• 5 yrs exp with HOSPITAL billing systems and third-party billing requirements,
• Bachelor’s Degree,
• Coding certification (CPC, CPCH, AHIMA etc),
• Epic Experience,
• Medicare, Midi-Cal and Commercial Payers processing.

Take on a significant role within a world-class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.

You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will:

• Analyze complex financial data
• Identify trends in revenue cycle operations
• Summarize data and present reports to leadership
• Serve as liaison with departments to thoroughly define reporting and information requirements
• Evaluate revenue cycle workflows to identify areas for improvement
• Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems
• Train patient financial services units on revenue cycle systems, processes and procedures
• Maintain compliance with government regulations, reimbursement issues, etc.
• Analyze hospital billing claims within the EHR and claim scrubber system
• Resolve claim errors, edits, and other holds
• Works with clinical and ancillary operational departments on correct coding, billing, and charging principles

We’re seeking a highly analytical, detail-driven professional with:

• Bachelor's degree in business, finance or related field
• CPC-H, CPC, or CCS coding certification
• Five or more years of experience with hospital billing systems and third-party billing requirements
• Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations
• Proficiency with Microsoft Excel
• Knowledge of Tableau Reporting dashboards
• Understanding of Medicare/Medi-Cal claims processing guidelines
• Experience with EPIC EHR, Cirius Claim Scrubber, or other EHR system
• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle
• Strong analytical and problem-solving abilities
• Excellent communication, interpersonal, and collaboration skills
• Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes

Job Type: Full-time

Pay: $30.00 - $34.00 per hour

Benefits:

• 401(k)
• 401(k) 4% Match
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• 8 hour shift

Work setting:

• Remote

Experience:

• HOSPITAL billing systems: 5 years (Preferred)
• Coding: 5 years (Preferred)
• Epic: 5 years (Preferred)
• Commercial Payers processing: 5 years (Preferred)

Work Location: In person