Hospital Billing & Follow Up Rep - Hybrid - 133362

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 Patient Biller III is responsible for the full range of hospital insurance billing, collections and credit balance account processing. This role responds to billing inquiries from patients, insurance companies and internal department team members; identifies and resolves account adjustments, resolves billing edits and processes account credit balances and insurance refund requests. Extensive knowledge of hospital medical insurance payers and plans, State and Federal rules/regulations related to billing hospital medical insurance claims. Extensive knowledge of medical insurance claim appeal submission processes , knowledge of medical terminology, ICD9, CPT, HCPCS, coding principles, self-pay collections and mandated charity laws. Extensive knowledge of HIPPA regulations and medical record submissions to support hospital claim billing. Department productivity and quality standards are expected to be performed at the expert level.

• Three (3) years of recent acute care hospital billing and collection experience.

• State and Federal rules and regulations related to billing facility medical insurance Claims.

• Demonstrated knowledge reviewing/processing hospital claim errors.

• Thorough knowledge of UB04 and revenue codes as it pertains to hospital billing.

• Extensive knowledge in submission of hospital claims appeals and basic knowledge in medical terminology, ICD9, CPT, HCPCS coding principles.

• Demonstrated knowledge of facility reimbursement contracts and reimbursement methodologies including but not limited to per diem, fee schedule, case rate and DRG's.

• Demonstrated knowledge reviewing/processing facility insurance refund requests and account credit balances.

• Epic Resolute experience.

• UB04 experience.

• Previous hospital billing experience.

• Previous hospital credit balance/refund processing experience.

• 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.

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

UC San Diego is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

For the University of California's Affirmative Action Policy please visit: https://policy.ucop.edu/doc/4010393/PPSM-20
For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.