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.