Make a positive impact on one of the nation's top health systems. Help ensure the efficient delivery of award-winning patient care. Take your professional expertise to the next level. UCan do all this and more at UCLA Health.
You will become a member of our highly successful Clinical Documentation Integrity and Denial Management team, including all modalities. This role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies.We're seeking a detail-oriented, collaborative, self-directed individual with:
*Bachelor's degree in health-related field, preferred
*A Registered Nurse (RN) license or MD diploma (or equivalent) required
*Three or more years of Clinical Documentation Integrity experience required, preferably at an AMC
*Knowledge of coding guidelines and coding clinic, required
*Knowledge of laws, rules and regulations regarding appropriate clinical documentation for Medicare, Medi-Cal, CCS etc.
*Strong leadership, supervisory, and training skills
*Excellent critical thinking abilities
*Experience working within EPIC and 3M 360 Encompass CAC, required
*Resourcefulness and strong communication, organizational, and analytical skills
*Ability to work effectively with physician/staff and interdisciplinary teams
*Computer proficiency and proficiency in Word, Excel and PowerPoint, required
*Skill in abstracting/interpreting medical information from patient records, required
*Clinical experience sufficient to understand and communicate medical diagnoses and courses of treatment to professional and non-professional personnel, required
*Knowledge of computer word processing, database programs, and ability to write reports and do graphical analysis, required
Note: Skills may be subject to test.
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