Payment Processing Associate - Hybrid - 140682

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. 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 Payment Processing Associate is responsible for the full range of billing duties within the revenue cycle from claim generation to final payment disposition. The Payment Processing Associate will monitor, prioritize, and ensure assigned work for the remittances of payments, resolution of edits, researching EOB's and all actions required to resolve reconciliation of batches and deposits in timely manner and in accordance with current departmental standards and performance metrics. The Payment Processing Associate is responsible for executing manual payment posting workflows by accurately allocating financial amounts, applying contractual adjustments, and documenting denial reason codes. The Payment Processing Associate works closely with internal customers and external business partners to take any and all assigned actions required to ensure the accurate and timely posting of insurance and self-pay payments to patient accounts.

• Three (3) years of relevant experience (Payment Posting and Reconciliation processes). One (1) year of recent experience specifically related to processing and resolving claims within a medical billing environment.

• 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.

• Knowledge of basic medical terminology, coding principles (CPT/HCPCS/ICD10/modifiers) and accounting/cash handling procedures.

• 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.

• Three (3) years of recent experience specifically related to processing and resolving claims within a medical billing environment.

• Prior Epic experience with Resolute Professional Billing.

• Experience with Payment Posting processes and knowledge of insurance EOB's, adjustment codes, and denial codes.

• Understanding of 835 files and remittances.

• Payment research and contacting payers experience.

• Payer portal knowledge.

• 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.