Hospital Billing & Follow Up Rep - Hybrid - 132354

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 Hospital Billing & Follow Up Rep is responsible for the full range of hospital insurance billing, collections and credit balance account processing. This role responds to billing inquiries from patients, insurance companies and internal department team members; identifies and resolves account adjustments, resolves billing edits and processes account credit balances and insurance refund requests. Extensive knowledge of hospital medical insurance payers and plans, State and Federal rules/regulations related to billing hospital medical insurance claims. Extensive knowledge of medical insurance claim appeal submission processes , knowledge of medical terminology, ICD9, CPT, HCPCS, coding principles, self-pay collections and mandated charity laws. Extensive knowledge of HIPPA regulations and medical record submissions to support hospital claim billing. Department productivity and quality standards are expected to be performed at the expert level.

• Three (3) years of recent acute care hospital billing and collection experience.

• State and Federal rules and regulations related to billing facility medical insurance Claims.

• Demonstrated knowledge reviewing/processing hospital claim errors.

• Thorough knowledge of UB04 and revenue codes as it pertains to hospital billing.

• Extensive knowledge in submission of hospital claims appeals and basic knowledge in medical terminology, ICD9, CPT, HCPCS coding principles.

• Demonstrated knowledge of facility reimbursement contracts and reimbursement methodologies including but not limited to per diem, fee schedule, case rate and DRG's.

• Demonstrated knowledge reviewing/processing facility insurance refund requests and account credit balances.

• Epic Resolute experience.

• UB04 experience.

• Previous hospital billing experience.

• Previous hospital credit balance/refund processing experience.

• 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.