Job description
Revenue Cycle Functions:
- Claim Submission: Incumbent to process paper and electronic claim forms to payors for chargeable and billable services. This includes resolving billing system edits (EDI/Charge Review) and determine the correction action to clear the error and produce clean claims for the Dental Center. Review key data within the claim form, such as provider, practice, CDT/CPT, fee and ensuring appropriate documentation is included for adjudication.
- Correspondence: Reviews billing correspondence for timely resolution. This will include applying appropriate denial and claim status codes. The incumbent is responsible to recognize insurance reimbursement issues, coding problems and other issues that could affect the financial condition of the clinic. The incumbents work closely with the Revenue Cycle Director to resolve identified trends and problems.
- Accounts Receivable by following up and reprocessing claims as necessary. This includes research complex billing issues of each account; confirms primary and secondary payers, closely evaluates coordination of benefits; identifies appropriate contract / plan to provide payment for all phases of care.
- Analyzes complex financial data and identifies trends that contributes to aging accounts and common denials. Summarizes findings to share with management
- Implement new systems and processes for managing the pursuit of unpaid or underpaid bills or claims, including drafting and submitting appeals letter to payors or escalation letters to patients.
- Patient Billing Inquiries: Collaborates with clinic managers/supervisors and providers (faculty, residents, students) to resolve billing inquires in-person, phone, email, standard mail, etc in a timely and professional manner. Educate patients of personal financial responsibility and expectation. This involves and in depth understanding of the basic dental insurance policies and the ability to communicate effectively to patients and payors. Nurture the patient relationship to encourage patient retention and contribute to the development of a patient-focus environment.
- The incumbent is responsible for collection and reconciliation of the cashier funds. This unit is responsible for reconciliation of the cashiering funds to the Axium Bank Report by Type, and for ensuring the Cash Handling Procedure is followed in the clinic. This includes the preparation and submission of daily journals for ATM, Lockbox and Credit Card deposits, ACH, eFT, i835 and insurance credit card payments using PeopleSoft. In addition to journal preparation, this position must maintain ancillary Excel spreadsheets for reconciliation, statistical and audit purposes.
- The incumbent prepares daily journals (Peoplesoft) to transfer the funds to our other SOD clinics and record the information in the excel database. The excel reports are generated by the incumbents for the MSO.
- The incumbent is responsible for the maintenance of the excel journal and deposit logs and the reconciliation of the monthly journals to ensure accuracy and completion against our weblinks reports. The SAS 112 reconciliation process is the responsibility of these employees. This position works closely with accounting and the controller’s office
- Treatment Planning includes the creation of financial arrangements, pre-authorization determination of benefits and payment plan agreements. The interpretation of treatment plans, verification of insurance coverage and options available to the patients are the responsibility of the incumbents.
- Serves as a resource for front desk and treatment planners; resolves systems, procedural and policy issues during daily operations. Contribute to the development of new administrative processes to streamline billing workflow and improve efficiency.
- Keeps abreast of changes in government regulations and requirements of all third-party carriers. Drafts changes to systems, policies and procedures as needed.
- Provides back up as needed in all areas of the PBS, which requires cross training all functions including treatment planning support in the clinic.
- Assist in the development of training material on changes to systems or operational procedures.
- Assist management with specific tasks, training, and special projects.
- Work independently within departmental guidelines, exercise appropriate judgement and function effectively as a member of the Patient Billing Service team.
- Prioritize workload and meet productivity, accuracy and meet service level/aging targets.
- Attend department, unit and other meetings as required.
- Complete trainings and University requirements within deadlines.
- Perform other duties as assigned.
Department Description
UCSF's Temporary Employment Program (TEP) recruits and hires temporary employees for immediate clerical and technical support services to UCSF Departments and various off-campus locations. UCSF departments deploy temporary employees to work on special projects, fill in for regular employees who are on vacation or leave, or to temporarily fill a vacant position during recruitment. Frequently temporary employees become successful candidates for career and limited appointment positions.
Required Qualifications
- At least 1 year of previous Insurance Follow up experience.
- High school graduation and four years of related administrative experience; or an equivalent combination of education and experience
- Demonstrate the Ability to communicate effectively (orally and written).
- Experience with MS EXCEL and OUTLOOK.
- Effective Time Management and Ability to Meet Deadlines
- Ability to work independently or as needed with a team.
- Ability to meet productivity and quality standards.
- Demonstrates positive attitude and excellent customer service skills.
- Proven ability to coach and mentor staff for optimal results
- Ability to set priorities, goals and objectives
- Demonstrate the ability to perform all aspects of billing and follow-up with superior quality.
- Excellent Attendance Record.
Preferred Qualifications
- Prior working knowledge of the EPIC (Apex) system, especially PB or HB Insurance Follow up Module(s).
- Prior experience in a medical office environment; strongly preferred
- knowledge of UC Peoplesoft
- Bachelor's degree in related area and/or equivalent experience/training
- Certified Procedure Coding (CPC)
- Certified Dental Coding (CDC)
- Associates or Bachelor’s Degree
About UCSF
The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world’s leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.
Pride Values
UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence – also known as our PRIDE values.
In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu
Join us to find a rewarding career contributing to improving healthcare worldwide.
In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu
Join us to find a rewarding career contributing to improving healthcare worldwide.
Equal Employment Opportunity
The University of California San Francisco 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, age, protected veteran or disabled status, or genetic information.
Organization
TEP
Job Code and Payroll Title
004621 COLL REPR SR
Job Category
Administrative Support, Financial, Professional (Non-Clinical), Support Services, Temporary Employment
Bargaining Unit
Teamsters Local 2010 - Clerical and Allied Services Unit (CX)
Employee Class
Temporary Employment
Percentage
100%
Appointment End Date
29-Sep-2023
Location
Parnassus Heights (SF)
Shift
Days
Shift Length
8 Hours
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