Physician Biller - Hybrid - 141923

Physician Biller - 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 Physician Biller is responsible for the full range of billing duties within the revenue cycle from claim generation to final payment disposition. The Physician Biller 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 Physician Biller 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.

Minimum Qualifications

• 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 payer communications 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.
• Prior Epic experience with Resolute Professional Billing.

Preferred Qualifications

• Some college coursework or an Associate Degree.
• Billing Certificate.
• Three (3) years of recent experience specifically related to processing and resolving claims within a medical billing environment.
• Experience with CMS-1500 Claims form.
• 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.
• Authorizations and Referrals 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.