#123198 Insurance and Patient Biller III - Hybrid/Remote

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.

Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

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 Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

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.