Insurance and Patient Biller III - Hybrid/Remote - 130207

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.

• Three (3) years of relevant experience: medical claims billing, denial mitigation and appeals. 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 payercommunications 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.

• Proficiency with MS Office Products (Mail, Excel & Word). Ability to type at least 25 wpm.

• 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.

• 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.