UCI Health · 3 weeks ago
Audit Professional 2 - Health Information - FT Days
Orange, CA
Full-time
Onsite
Mid, Senior Level
5+ years expUCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. The Audit Professional 2 is responsible for conducting audits of medical records, ensuring compliance with various regulations, and providing education to healthcare providers to enhance documentation practices.
Health CareHospitalMedical
No H1B
Responsibilities
Conducting both concurrent and retrospective audits of medical records to ensure the presence and timeliness of clinical information as defined by the Medical Staff General Rules and Regulations, Title 22, Medicare’s Conditions of Participation and Joint Commission requirements
Review records for evidence of documentation of medical necessity criteria in response to payment denials/chart requests from insurance companies
Compile data of the findings from the reviews and prepares reports for the Director for presentation at various committee meetings
Analyze and identify patterns and trends to identify opportunities for improvement
Participate in physician and other health care providers education to facilitate documentation within the medical record
Assist with the coordination of the forms committee to ensure forms content is compliant with outside regulatory requirements
Assist with other medical record related functions as required or assigned
Qualification
Required
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Must demonstrate customer service skills appropriate to the job
Extensive knowledge of Joint Commission physician documentation requirements, Medicare's Conditions of Participation, Title 22 documentation requirement and Medicare's National and Local Coverage Determination Medical Necessity requirements for procedure performance
Excellent written and verbal communication skills in English
Demonstrated knowledge of medical terminology
Demonstrated experience with database information retrieval and analysis
Demonstrated ability to compare data from a variety of sources and accurately identify variances or discrepancies in the data
Attention to details with the ability to troubleshoot and pursue problems to satisfactory resolution
Analytical skills to identify problems, conduct research, analyze data and determine solutions
Advanced computer skills to include navigation and operation of MS office products (Word, Excel, PowerPoint, Access), with the ability to run various reports
Ability to understand and correctly interpret clinical documentation contained in an electronic medical record
Ability to maintain a work pace appropriate to the workload
Ability to establish and maintain effective working relationships across the Health System
5 years previous experience working with an electronic health record system
Preferred
Working knowledge of EPIC electronic health record
Knowledge of University and medical center organizations, policies, procedures and forms
Benefits
Medical insurance
Sick and vacation time
Retirement savings plans
Access to a number of discounts and perks
Company
UCI Health
UCI Health offers acute and general care services specializing in treating urology, gynecology, kidney disorders, and cancer programs.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Manlin Kitty Huang Lin, MS, CPA
Director of Finance/ CFO
Nate Shinagawa MHA, FACHE
Chief Operating Officer and Senior Vice President
Recent News
Precedence Research
2025-11-27
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