University of California - Oakland, CA

posted 4 months ago

Full-time - Entry Level
Oakland, CA
Educational Services

About the position

The Insurance & Patient Biller III at UC San Diego Health is responsible for managing the complete billing process within the revenue cycle, from claim generation to final payment disposition. This role involves monitoring and prioritizing billing tasks, resolving claims edits, and ensuring timely actions are taken to address open accounts receivable. The position requires collaboration with internal and external partners to ensure accurate and efficient billing for patients, contributing to the organization's mission of delivering outstanding patient care.

Responsibilities

  • Manage the full range of billing duties from claim generation to final payment disposition.
  • Monitor and prioritize assigned work for billing claims and resolution of edits.
  • Ensure timely actions are taken to resolve open accounts receivable in accordance with departmental standards.
  • Collaborate with internal customers and external business partners to ensure accurate billing and resolution of claims.

Requirements

  • Three years of relevant experience in medical claims billing, denial mitigation, and appeals.
  • One year of recent experience in processing and resolving claims within a medical billing environment.
  • Extensive knowledge of medical insurance billing processes, billing documents, claim forms, HIPAA, and PHI.
  • 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 procedures.
  • Ability to read and understand insurance EOBs and payer communications to resolve outstanding bills.
  • Detail-oriented with excellent written and verbal communication skills.
  • Self-motivated and able to work independently as well as part of a team.
  • Proficiency with MS Office Products (Mail, Excel & Word) and typing at least 25 wpm.

Nice-to-haves

  • Some college coursework or an Associate Degree.
  • Prior Epic experience with Resolute Professional Billing.
  • Billing Certificate.
  • Three years of recent experience specifically related to processing and resolving claims within a medical billing environment.
  • Familiarity with reading medical records to support medical necessity based on diagnosis and services rendered.
  • Understanding of how to obtain different types of payer information timely and prioritize workload accordingly.
  • Comfortable with verifying patient coverage and insurance verification via payer portals or phone.

Benefits

  • Health insurance coverage
  • Dental insurance coverage
  • Vision insurance coverage
  • 401k retirement savings plan
  • Paid holidays
  • Flexible scheduling options
  • Professional development opportunities
  • Employee discount programs
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