Req ID: 151274
Payroll Job Title: 008794-CLIN APPLICATIONS PROFL
Location(s): Orange, California
Organization: ['UCI Health']
Division: ['Medical Center']
Department: ['Health Information']
Reports To Title: ['005752-HEALTH INFO MGT MGR 2']
Position Type: Full Time
Salary Range Minimum: USD $100,100.00/Yr.
Salary Range Maximum: USD $187,500.00/Yr.
UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.
As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.
The incumbent supervises the development, enhancement, optimization, validation, and ongoing support of network coding applications and related health information technologies, with a primary focus on the organization's network coding platform and associated applications (e.g., Solventum, Cirius, SmarterDx, CAC technologies, CDI applications, and other coding and reimbursement systems). Independently manages large functional areas of the network coding application environment. Applies advanced expertise in ICD-10-CM/PCS, CPT, HCPCS, and official coding and reimbursement guidelines to evaluate, configure, and optimize coding system functionality based on operational, regulatory, and business requirements. Facilitate strategic decisions and operational initiatives that impact coding compliance, reimbursement integrity, revenue cycle performance, quality reporting, and regulatory reporting across the network. Participates in the analysis, design, implementation, integration, and maintenance of network coding applications and their interfaces with the electronic health record and other clinical and financial systems. Leads the development and oversight of system validation rules, automation, and coding edits to ensure compliant and accurate code assignment, while collaborating with coding operations, clinical documentation integrity, information technology, vendors, and other network stakeholders to evaluate user feedback, identify system enhancement opportunities, and implement solutions that improve coding accuracy, compliance, and operational efficiency. Working collaboratively with Health Information Management (HIM), Revenue Integrity (RI), Clinical Documentation Integrity (CDI), Patient Financial Services (PFS), Information Technology (IT), and other operational stakeholders, the professional evaluates departmental and interdepartmental workflows to identify opportunities for sustainable process improvement. This role leverages expertise in coding regulations, reimbursement methodologies, and external reporting requirements, including HCAI, AHRQ, Vizient, and CMS quality programs—to ensure workflow and system design decisions support accurate coding, reimbursement, regulatory reporting, and organizational performance across the network.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS).
Must demonstrate customer service skills appropriate to the job
Minimum of five (5) years of progressively responsible experience in acute care inpatient and/or outpatient facility coding, coding compliance, coding quality, coding technology, health information management, or revenue cycle operations.
Experience evaluating coding workflows, analyzing business and regulatory requirements, and translating operational needs into system configurations, validation rules, edits, automation, and workflow enhancements that improve coding accuracy, compliance, and operational efficiency.
Experience developing or maintaining automated coding edits or clinical decision support.
Experience collaborating with Information Technology, Health Information Management, Revenue Cycle, Clinical Documentation Integrity, clinical operations, software vendors, and executive leadership to implement network coding solutions and resolve complex system issues.
Excellent written and verbal communication skills in English
Excellent analytical, organizational, project management, written, and verbal communication skills with the ability to lead cross-functional initiatives, facilitate stakeholder engagement, and communicate complex technical and regulatory concepts to diverse audiences.
Demonstrated expertise utilizing network coding applications and technologies, including computer-assisted coding (CAC), clinical documentation integrity (CDI), coding workflow, reimbursement optimization, and coding quality platforms such as Solventum, Cirius, SmarterDx, Epic, and other network coding or revenue cycle applications
Demonstrated ability to independently manage multiple complex initiatives, establish priorities, meet project deadlines, and function as the network subject matter expert for coding application functionality, compliance, and system optimization.
Demonstrated ability to analyze complex coding, reimbursement, compliance, and operational issues using data analytics and reporting tools to identify trends, develop recommendations, and implement network-wide solutions.
Associate’s degree in Health Information Management, Healthcare Administration, Business Administration, or a related healthcare field.
Advanced knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Official Coding Guidelines, Coding Clinic, CMS reimbursement methodologies (MS-DRG, APR-DRG, OPPS/APC), National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), and applicable federal and state coding and reimbursement regulations.
Ability to maintain a work pace appropriate to the workload
Knowledge of healthcare interoperability standards, system interfaces, and data exchange between electronic health records, coding applications, billing systems, and third-party vendors.
Knowledge of University and Medical Center organizations, policies, procedures and forms
Experience working in a large, integrated, multi-hospital healthcare system with network-wide coding and revenue cycle operations.
Experience utilizing business intelligence and analytics tools such as Microsoft Power BI, SQL, Tableau, or similar platforms to evaluate coding performance, compliance, reimbursement, or operational metrics.
Experience providing education or consultation to operational teams regarding coding system functionality, workflow optimization, and regulatory changes.
Epic certification(s) related to HIM, Hospital Billing, Revenue Cycle, or Clinical applications.
Bachelor's or Master's degree in Health Information Management, Health Informatics, or Healthcare Administration
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.
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:
*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.
Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php
The University of California is an Equal Opportunity 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 Anti-Discrimination 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.
Must be able to provide proof of work authorization
