The Quality Assurance Analyst/Trainer in Patient Financial Services (PFS) is an experienced professional who applies theory and puts it into practice with in-depth understanding of the hospital revenue cycle. Designs audit programs to accomplish review objectives. Proactively identifies and addresses quality issues that result in delayed and/or decreased reimbursement. The primary responsibilities span the entire Revenue Cycle and include staff Quality Review (QR) scoring, quality analysis, identification of global quality issues, and training support. May provide functional advice, training and/or guidance to supervisors.Evaluates revenue cycle workflows to propose improvements in efficiencies and timeliness. Collaborates with and coordinates between departments to design new workflows, in order to maximize revenues. Functions independently with full understanding of all components of the revenue cycle. Completes complex projects of diverse scope and/or portions of large projects. Understands and applies industry practices, community standards and department/unit policies and procedures relating to work assignments. May serve as technical lead for a project of moderate scope. Trains users. Liaisons with departments to thoroughly define reporting and information requirements. Identifies data sources, develops and delivers routine and ad hoc reports and presentations. Proposes changes or enhancements to systems to improve reporting capabilities.REQUIRED:--In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including registration, authorization, billing, collections, contractual adjustments, third-party reimbursements, and cash management--Seasoned, experienced professional with a full understanding of industry-wide business process and analysis practices related to hospital billing and follow-up/reimbursement procedures, for Commercial/Managed Care and Government payers and programs. Experience with contracts as it pertains to division of financial responsibility and evaluating billing and reimbursement terms.Public speaking skills and experience facilitating group discussions--Experience using billing codes and coding systems, including CPT, HCPCS, Revenue Codes, and ICD-9/10--Experience with a variety of reporting and data organizational tools and other software applications including, but not limited to Microsoft Excel, Business Objects, Word, Power Point, Visio and Outlook--Knowledge of major healthcare trends and issues that affect physicians, hospitals and academic health centers--Strong knowledge and broad understanding of third party hospital billing and collections, including but not limited to Medicare, Medicare HMO, Medi-Cal, Managed Care Medi-Cal, major commercial and workman's compensation payers--Broad knowledge of finance, accounting, business and systems operations--Demonstrated expertise with the EPIC Resolute billing application and its functions--Public speaking skills and experience facilitating group discussionsExperience with a variety of reporting and data organizational tools and other software applications including, but not limited to Microsoft Excel, Business Objects, Word, Power Point, Visio and Outlook. --Process general instructions on routine audit work with detailed instruction on new or more complex audit assignments--Knowledge of major healthcare trends and issues that affect physicians, hospitals and academic health centersPREFERRED:--Knowledge of INVISION and/or EPIC billing system, particularly basic functions, database structure, and reporting capabilities--Knowledge of Huron reporting tools and reporting capabilities--Knowledge of Health System methods, policies and procedures
About University of California Davis Medical Center
At the end of 2015, we launched a comprehensive and inclusive process to tap into the broad, diverse knowledge of our entire UC Davis Health community to stimulate new and unique ideas for our next strategic plan.Throughout 2016, hundreds of members of our UC Davis Health family, as well as external friends and partners, took part in conversations and provided valuable input into charting a long-t...erm course for our future that will continue the momentum underway to solidify our position as a top-tier health care organization.With your valuable input and talents, I am excited to launch our six new strategic plan goals. Over the next few years, together we will:Lead Person-Centered Care in the best way, at the best time, in the best place, and with the best teamReimagine Education by cultivating diverse, transdisciplinary, life-long learners who will lead transformation in health care to advance well-being and equity for allAccelerate Innovative Research to improve lives and reduce the burden of disease through the discovery, implementation and dissemination of new knowledgeImprove Population Health through the use of big data and precision healthTransform Our Culture by engaging everyone with compassion and inclusion, by inspiring innovative ideas, and by empowering each otherPromote Sustainability through shared goals, balanced priorities and investments in our workforce and in our communityAt a time when our industry is experiencing some of the most formidable changes ever, these are bold aspirations that will anchor us and provide us with clarity of purpose and a path forward. I am fully confident that we will achieve great success knowing we have a solid plan and areas of focus to guide us.I thank everyone who participated in the planning process for their great input and their dedication to our future success.