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Audit and Appeal Specialist
UCLA
Application
Details
Posted: 21-Oct-25
Location: Los Angeles, California
Categories:
Admin / Clerical
Internal Number: 149502310
Description
Contribute to the success of a world-class healthcare organization by ensuring compliance in regulatory audits and appeals. Leverage your expertise to support UCLA Health’s commitment to accuracy and quality in claim processing.
As an Audit and Appeals Specialist, you will:
Facilitate responses to regulatory audits related to billing, coding, and collection practices in compliance with federal and state guidelines
Collect, analyze, and enter audit requests into relevant systems, distributing requests to necessary teams
Monitor audit response and appeal statuses, tracking cases and maintaining updated records in various systems
Review claim denials for clinical issues, prepare appeals, and manage each case's resolution process
Support reporting on audit trends, outcomes, and compliance initiatives
Join UCLA Health to uphold high standards in healthcare auditing and compliance, contributing to operational excellence.
Salary Range: $31.51 - $62.64 per hour.
Qualifications
We’re seeking a knowledgeable, detail-oriented professional with:
Bachelor’s degree in a clinical or related field, or equivalent training and experience
Certification in clinical coding or compliance, strongly preferred
Basic understanding of audit and appeals processes, including methods, tools, and regulatory standards affecting claims submission and payment
Project management skills, including effective time management, prioritization of competing priorities, and the ability to address complex issues and risks to ensure projects meet schedules and budgets
Strong collaboration skills to work effectively with internal and external stakeholders
Excellent communication skills, with the ability to convey complex clinical and technical information clearly and concisely, both in writing and verbally
Ability to contribute to high-quality reporting and documentation, including the development of training materials for diverse stakeholder groups
At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.