UCSD Layoff from Career Appointment: Apply by 10/26/2020 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 11/04/2020. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will remain open until filled.
The Insurance & Patient Biller III is responsible for the full range of billing duties within the revenue cycle from claim generation to final payment disposition. The Insurance & Patient Biller III will monitor, prioritize and ensure assigned work for the billing of claims, resolution of edits, attaching of records and all actions required to resolve open A/R are being addressed in a timely manner and in accordance with current departmental standards and performance metrics. The Insurance & Patient Biller III works closely with internal customers and external business partners to take any and all assigned actions required to ensure the accurate and timely billing/resolution of claims for our patients.
High School Diploma or GED.
Medical Terminology training and/or certificate or equivalent experience.
Minimum of three (3) years of medical claims billing, denial mitigation and appeals.
Must have extensive knowledge in Insurance claims appeals, and range of knowledge in ICD-10, CPT, and HCPCS coding principles.
Must have knowledge of CMS 1500 claims rules as it pertains to physician billing.
Extensive knowledge of medical insurance billing/processes, billing documents, claim forms, HIPAA, PHI, and a thorough understanding of state and federal rules for billing and appealing medical claims.
Strong proficiency with MS Office Products (Mail, Excel and Word). Ability to type at least 30 wpm.
Ability to be able to read/understand insurance EOBs, Correspondence and other payer communications in order to resolve outstanding bills.
Customer focused mindset. Detail-oriented, organized, and possesses excellent written and verbal communication skills.
Self-motivated and comfortable working independently as well collaborating as part of a team to accomplish common goals.
Some college coursework or an Associate Degree.
Prior Epic experience with Resolute Professional Billing.
Three (3) years of recent experience specifically related to processing and resolving claims within a medical billing environment.
Familiar with reading medical records in order to submit records to support medical necessity based on diagnosis and services rendered.
Clear understanding or know how to properly obtain the different types of payer information timely and how to prioritize workload based on the payer specific info.
Capable and comfortable with verifying patient coverage/insurance verification and adjudication via a payer portal, Epic system or by phone.
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.
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