Hospital Billing & Follow Up Rep - Hybrid - 131436

About the position

UC San Diego Health's Revenue Cycle department is dedicated to supporting the organization's mission of delivering outstanding patient care and creating a healthier world, one life at a time. As a member of this diverse, patient-focused, and high-performing team, the Patient Biller III plays a crucial role in ensuring the financial health of the organization through effective billing and collections processes. This position is designed for individuals who are passionate about problem-solving and customer service, and who thrive in a fast-paced and innovative environment. The role involves a hybrid work schedule, combining both onsite and remote work, which allows for flexibility while maintaining productivity and quality standards. The Patient Biller III is responsible for the full range of hospital insurance billing, collections, and credit balance account processing. This includes responding to billing inquiries from patients, insurance companies, and internal department team members. The role requires identifying and resolving account adjustments, processing account credit balances, and handling insurance refund requests. A deep understanding of hospital medical insurance payers and plans, as well as State and Federal regulations related to billing hospital medical insurance claims, is essential. The position also demands extensive knowledge of medical insurance claim appeal submission processes, medical terminology, and coding principles, including ICD9, CPT, and HCPCS. Adherence to HIPAA regulations and proper medical record submissions to support hospital claim billing are also critical components of this role. In this position, the Patient Biller III is expected to perform at an expert level in terms of department productivity and quality standards, ensuring that all billing processes are executed efficiently and accurately. The role is integral to the financial operations of UC San Diego Health, contributing to the overall mission of providing exceptional patient care while maintaining the financial integrity of the organization.

Responsibilities
? Perform full range of hospital insurance billing, collections, and credit balance account processing.
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? Respond to billing inquiries from patients, insurance companies, and internal department team members.
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? Identify and resolve account adjustments and billing edits.
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? Process account credit balances and insurance refund requests.
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? Maintain extensive knowledge of hospital medical insurance payers and plans.
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? Ensure compliance with State and Federal rules and regulations related to billing hospital medical insurance claims.
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? Review and process hospital claim errors and appeals.
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? Utilize knowledge of UB04 and revenue codes as it pertains to hospital billing.
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? Handle facility reimbursement contracts and reimbursement methodologies.
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? Review and process facility insurance refund requests and account credit balances.

Requirements
? Three (3) years of recent acute care hospital billing and collection experience.
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? Knowledge of State and Federal rules and regulations related to billing facility medical insurance claims.
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? Demonstrated knowledge in reviewing and processing hospital claim errors.
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? Thorough knowledge of UB04 and revenue codes as it pertains to hospital billing.
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? Extensive knowledge in submission of hospital claims appeals and basic knowledge in medical terminology, ICD9, CPT, HCPCS coding principles.
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? Demonstrated knowledge of facility reimbursement contracts and reimbursement methodologies including per diem, fee schedule, case rate, and DRGs.
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? Demonstrated knowledge in reviewing and processing facility insurance refund requests and account credit balances.

Nice-to-haves
? Epic Resolute experience.
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? Previous hospital billing experience.
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? Previous hospital credit balance/refund processing experience.

Benefits
? Medical insurance
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? Pay Transparency Act compliance
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? Annual Full Pay Range: $58,213 - $72,370 (prorated if appointment percentage is less than 100%)
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? Hourly Equivalent: $27.88 - $34.66
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? Employment subject to a criminal background check and pre-employment physical.

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