Hospital Billing, Follow Up & Denials Rep Hybrid

Hospital Billing, Follow Up & Denials Rep Hybrid

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 HIPAA regulations and medical record submissions to support hospital claim billing. Department productivity and quality standards are expected to be performed at the expert level.

Minimum Qualifications

• Three (3) years of recent acute care hospital billing and collection experience.
• Knowledge of medical insurance and State and Federal rules and regulations related to billing Insurance Claims.
• Extensive knowledge in Insurance claims appeals, and range of knowledge in ICD-9, CPT, HCPCS coding principles.
• Knowledge in self-pay collections.
• Knowledge of UB04 and revenue codes as it pertains to billing.

Preferred Qualifications

• Epic Resolute experience.
• UB04 experience.
• Previous hospital billing experience.
• Previous hospital credit balance/refund processing experience.

Special Conditions

• 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: $61,116 - $75,982 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $29.27 - $36.39

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).

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.