[Hiring] Senior Professional Fee Coding Specialist @UCSF

Role Description

Patient Records Abstractor fulfills a role as a Medical Coder for UCSF’s physician practices. They review patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. They apply national and international coding classifications to ensure records reflect the care delivered, supporting accurate reimbursement and reliable clinical data.

• Knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), and Healthcare Common Procedural Coding System (HCPCS).
• Operate within a healthcare records or billing team.
• Close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries.
• Maintain currency with coding updates, compliance requirements, and professional standards.
• Participate in regular audits to monitor coding quality.
• Process assigned case volumes in a timely manner while maintaining high accuracy.
• Adhere to confidentiality and information governance standards.
• Contribute to process improvements that enhance data quality and coding efficiency.

Qualifications

• Experience in medical coding and billing.
• Strong understanding of coding regulations and compliance.
• Ability to analyze complex coding data and identify trends.
• Excellent communication and collaboration skills.

Requirements

• Review and code complex patient encounters in assigned work queues.
• Work in moderate and simple work queues as needed.
• Process RFI and edit work queues as needed.
• Maintain a minimum 95% coding accuracy rate.
• Meet productivity standards established by UCSF leadership.
• Collaborate proactively with clinical divisions to support compliant revenue cycle practices.
• Code complex procedures and accounts requiring advanced expertise in charge capture, workflow, hospital operations, authorizations, and the revenue cycle.
• Resolve Claims Manager and Epic edits through documentation review.
• Use dashboards and reporting processes to analyze complex revenue cycle functions and audit data.
• Complete coding-related work reports, reconcile charge lists, create charge sessions, update department information, and follow up on credentialing requests.
• Serve as a lead resource on applicable billing, coding, and revenue cycle regulations.
• Teach and train team members within designated specialty and subspecialty areas.
• Stay current with coding audits, regulations, trends, and payer requirements.
• Research and review coding directives issued by OIG, CMS, intermediaries, and national and local insurance carriers.
• Analyze complex coding data, identify revenue cycle trends, and prepare reports for leadership.

Benefits

• Comprehensive health benefits.
• Retirement plans.
• Professional development opportunities.
• Work-life balance initiatives.

Company Description

The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences.

• Home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging, and stem cells.
• Committed to equity in care delivery and workforce diversity.