Patient Assistance Specialist - 127896
#127896 Patient Assistance SpecialistExtended Deadline: Thu 3/7/2024
UC San Diego values equity, diversity, and inclusion. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.
UCSD Layoff from Career Appointment: Apply by 2/12/24 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 2/21/24. Eligible Special Selection clients should contact their Disability Counselor for assistance.
UC San Diego Health's Pharmacy 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 patient assistance and some pharmacy billing duties within the prescription billing cycle from claim generation to final pharmacy payment disposition. The Insurance & Patient Biller III will monitor, prioritize and ensure assigned work for the resolution of pharmacy claims, resolution of edits, attaching of records and all actions required to resolve open requests 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 and pharmacy claims billing, denial mitigation and appeals.
Extensive knowledge of pharmacy and medical insurance billing/processes, billing documents, claim forms, HIPAA, PHI, and a thorough understanding of state and federal rules for billing and appealing pharmacy and medical claims. Knowledge of eligibility criteria of pharmaceutical companies and foundations.
Strong proficiency with MS Office Products (Mail, Excel and Word).
Detail oriented, with organizational skills and the ability to manage time efficiently, prioritize tasks, and complete assignments consistently on schedule
Basic communications skills, with the ability to interpret and present clinical financial information clearly and concisely
- Extensive knowledge in navigating Epic (Electronic Medical Record).
- Familiar with reading medical and pharmacy 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.
- Knowledge of reporting instruments and metrics on a monthly basis.
- Knowledge of acquisition no-cost drug programs.
- Bilingual (Spanish preferred).
- Knowledge of reviewing, analyzing and managing assistance contracts between patients and drug companies.
- 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.
Pay Transparency Act
Annual Full Pay Range: $56,522 - $70,261 (will be prorated if the appointment percentage is less than 100%)
Hourly Equivalent: $27.07 - $33.65
Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).
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 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
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UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.