Remote Medical Insurance Verification Jobs in Berkeley, CA

Location: Fully Remote
Employment Duration: 3 months
Schedule: Full-Time | Day Shift
Pay Range: $53.12-$66.18/hour
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. They have knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), and Healthcare Common Procedural Coding System (HCPCS). The role operates within a healthcare records or billing team and requires close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries. Coders must 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, and contribute to process improvements that enhance data quality and coding efficiency.
Department Overview:
The Faculty Practice Revenue Management Operations (FPRMO) department is responsible for physician-based coding for UCSF faculty. The team ensures accurate code assignment for professional services delivered across UCSF locations, affiliated community hospitals, off-license practices, and ambulatory clinics.
FPRMO supports a diverse group of providers, including physicians, nurse practitioners, and advanced practice providers, across a wide spectrum of specialties within an academic medical center environment. These specialties include Neurosurgery, Cardiovascular Services, OB/GYN, Gender Reassignment, Rheumatology, and Plastic Surgery.
FPRMO plays a critical role in the revenue cycle by delivering precise and compliant coding for approximately 1.6 million patient encounters annually, supporting both regulatory requirements and optimal reimbursement.
Key Responsibilities:

• 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, including evaluation and management (E/M) leveling, diagnosis coding, bundling issues, modifier usage, and related coding requirements.
• Use dashboards and reporting processes to analyze complex revenue cycle functions and audit data supporting revenue cycle management.
• 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 and communicate regulatory updates to faculty, management, and staff.
• Teach and train team members within designated specialty and subspecialty areas.
• Stay current with coding audits, regulations, trends, Office of Inspector General (OIG) initiatives, and payer requirements affecting assigned specialties.
• 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.

Responsibilities
N/A
Qualifications
Required Qualifications:

• 5+ years of professional fee/revenue cycle coding experience or equivalent experience/training.
• Professional fee coding experience in Cardiology/Cardiovascular Services.
• Hands-on experience with cardiac catheterization coding.
• Experience coding electrophysiology studies and procedures.
• Experience with non-invasive Cardiology coding, including echo, stress testing, ECG/EKG, and remote cardiac monitoring.
• Experience coding cardiac device interrogations and related monitoring services.
• Advanced knowledge of cardiovascular CPT coding, ICD-10-CM, HCPCS, modifiers, bundling, and clinical documentation requirements.
• Knowledge of federal, state, and commercial payer coding and billing standards.

Required certification/licensure:

• CPC, CCS-P, CCA, CCS, RHIT, RHIA, or equivalent licensure approved by FPRMO management.

Preferred Qualifications:

• Bachelor's degree in a related field and/or equivalent experience/training.
• Prior experience in an academic medical center.
• Prior experience with Epic.
• Prior experience with Encoder Pro.

About Us
About UCSF
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. We bring together the world's leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.
Pride Values
UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.
In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available here.
Join us to find a rewarding career contributing to improving healthcare worldwide.
Equal Employment Opportunity
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 status under state or federal law.
Salary Information
The final salary and offer components are subject to additional approvals based on UC policy.
Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.
To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html