Denials & Internal Audit Manager - HB Patient Financial Services - FT Days - University of California, Irvine

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.

To learn more about UCI Health, visit www.ucihealth.org.

Position Summary:

Incumbent is responsible for the day to day management of all functions and oversight of all activities related to monitoring and appealing of denials/underpayments received from Third Party Payers, including Managed Care appeals. The Manager will serve as the key liaison between PFS, Case Management, Contracting, Admitting/Registration, Call Center and other team members within the organization regarding denials and appeals. The Manager is also responsible for supervising staff, tracking denials, meeting with payers to resolve issues and ensuring denials are addressed in a timely manner (resulting in timely collections).

Total Compensation

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Required Qualifications:

• Project Management: assesses work activities and allocates resources appropriately
• PC Skills: demonstrates proficiency in Microsoft Office applications and others as required
• Organization: proactively priorities needs and effectively manages resources
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Minimum of 5 years supervisory/management experience
• Minimum of 10 years directly related work experience, in a healthcare setting
• Leadership: guided individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
• Excellent written and verbal communication skills in English
• Customer orientation: establishes and maintains long-term customer relationships, building trust and respect by consistently meeting or exceeding expectations
• Communication: communicates clearly and concisely
• Ability to maintain a work pace appropriate to the workload

Preferred Qualifications:

• Prior payer analysis experience
• Bachelor’s degree in Health Care Management, Business, Finance or Accounting or an equivalent combination of education and experience

Conditions of Employment:

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement:

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m.