Insurance and Patient Biller III - 111688
As a federally-funded institution, UC San Diego Health maintains a marijuana and drug free campus. New employees are subject to drug screening.
#111688 Insurance and Patient Biller IIIInitial Review Date: Mon 1/3/2022
For the safety and well-being of the entire university community, the University of California requires, with few exceptions, that all students, faculty and staff be vaccinated against the COVID-19 virus and influenza before they will be allowed on campus or in a facility or office. For more information visit: Flu Vaccine Mandate / COVID Vaccine Policy
UCSD Layoff from Career Appointment: Apply by 10/01/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 10/13/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will remain open until filled.
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.
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.
- 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.
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
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.
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.