This position desires someone with a strong background in hospital/facility revenue cycle/coding. The Billing and Coding Compliance Manager supports the efforts of the Revenue Cycle Compliance component of the UCSD Healthcare Compliance Program through adherence and promotion of functions which correspond to the seven elements of an "effective compliance program." The Manager functions as a lead subject matter expert and authoritative resource for interpretation and application of documentation, coding and billing rules and regulations for hospital and professional services across the organization. The Manager performs complex analyses and collaborates with functional areas and stakeholders to identify and mitigate potential revenue cycle compliance issues. Creates, develops and revises basic to complex revenue cycle compliance standards, policies and procedures and education. Provides advice and oversight to Compliance Analysts within revenue cycle compliance pertaining to Professional and/or Hospital settings. Applies extensive knowledge of healthcare industry regulatory affairs concepts to substantial projects of large scope and high degrees of complexity.

Responsibilities include:

• Report to the Director of Billing and Coding Compliance

• Support the efforts of the Revenue Cycle Compliance component of the UCSD Healthcare Compliance Program through adherence and promotion of functions that correspond to the seven elements of an "effective compliance program."

• Function as a lead subject matter expert and authoritative resource for interpretation and application of documentation, coding and billing rules and regulations for hospital and professional services across the organization

• Perform complex analyses and collaborate with functional areas and stakeholders to identify and mitigate potential revenue cycle related compliance issues

• Create, develop and revise basic to complex revenue cycle compliance standards, policies and procedures and education

• Create and monitor the Revenue Cycle component of the Annual Compliance Workplan

• Provide advice and oversight to the Sr. Compliance Analysts within revenue cycle compliance

• Nine (9) years of related experience, education/training, OR a Bachelor's degree in related area plus five (5) years of related experience/training.

• Experience and advanced knowledge of current HIPAA regulations, state privacy laws, and medical center and UC procedures.

• Ability to implement HIPAA and other privacy regulations, and utilizes knowledge of clinical operations and patient care work-flow to provide guidance to departments and providers.

• Expert knowledge of the clinical and operational issues regarding compliance and assessing risk.

• Certified in professional and inpatient coding (AHIMA or AAPC).

• Two or more years of manager level experience and direct supervision of team members in healthcare compliance or closely related area.

• Certified in Healthcare Compliance.

• Certified in Medical Auditing.

• Experience working with MD Audit.

• Experience working with EPIC.

• This is a hybrid position that may require physical attendance at monthly All-Staff meetings and occasional on-site presence.

• Must be able to work various hours and locations based on business needs.

• Employment is subject to a criminal background check and pre-employment physical.