Patient Biller III - Hybrid - 132668

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 Patient Biller III is responsible for the full range of insurance and self-pay accounts and department credit balances. Responds to billing inquiries from patients, insurance companies and departments. Identifies and resolves issues regarding account adjustments, re-billing insurance, and/or collecting from patients as appropriate. Extensive 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, ICD-10 CPT, HCPCS, coding principles. Knowledge in self-pay collections and mandated charity laws. Knowledge of medical/surgical terminology. Knowledge of accounting and cash handling principles and various billing documents and claim forms. Responsible to work system generated claims, edits, attaches records, operative reports and all system reports. Job standards are expected to be performed at the EXPERT level.

• Three years recent acute care hospital billing and collection experience.

• State and Federal rules and regulations related to billing Insurance Claims.

• Demonstrated knowledge in self-pay collections.

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

• Extensive knowledge in Insurance claims appeals, and range of knowledge in ICD9, ICD-10, CPT, HCPCS coding principles.

• Knowledge of Hospital payer contracts and reimbursement methodologies including but not limited to per diem, fee schedule, case rate and DRG's.

• Epic Resolute experience.

• Previous hospital billing experience.

• Experience with Government payers i.e. Medicare/ Medi-Cal.

• 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.