Career Center
La Jolla, California
Birmingham, Alabama
St. Louis, Missouri
Philadelphia, Pennsylvania
Mount Pleasant, Michigan
Portland, Oregon
Philadelphia, Pennsylvania
Posted: 07-Jan-23
Location: La Jolla, California
Salary: Open
Internal Number: 117056
UCSD Layoff from Career Appointment: Apply by 06/30/22 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 07/05/22. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will work a hybrid schedule which includes a combination of working both onsite at Greenwich Drive and remote.
This position will remain open until filled.
Placement within the salary range is determined by internal equity, relevant qualifications, and collective bargaining agreements (when applicable).
DESCRIPTION
UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world — one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.
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.
MINIMUM QUALIFICATIONS
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.
PREFERRED QUALIFICATIONS
- Some college coursework or an Associate Degree.
- Prior Epic experience with Resolute Professional Billing.
- Billing Certificate.
- 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.
SPECIAL CONDITIONS
- 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.
Pay Transparency Act Full Salary Range: $54,873 - $68,215 Annually
The University of California, San Diego is required to provide a reasonable estimate of the compensation range for this role. This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience.
