Insurance Billing Specialist (Transplant) - Patient Accounting - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Keck Medicine of USC is a community creating a lasting impact in healthcare. Every team member contributes to a culture built on growth, collaboration, and well-being.

About the role

The Transplant Billing Specialist reports directly to the Billing Supervisor in the Patient Accounting Department. This role maintains a current understanding of specialized (Global Transplant Billing process), payer-specific, and transplant billing requirements to ensure claims are billed in accordance with contract agreements for all government and non-government payers.

Responsibilities

• Daily review and resolution of claim edits in the billing scrubber, ensuring claims are billed within 48–72 hours of creation date.
• Review of medical charts for accuracy of transplant date and payer-specific billing guidelines, including contract review and payer communication.
• Ensure accounts are coded with the proper health plan (payer) according to eligibility and patient insurance card.
• Manual claim splitting based on contract-specific stipulations; manual creation of itemized bills to match split claims.
• Collaborate with internal units to obtain invoices and other claim attachments.
• Collaborate with USC Care Medical Group to obtain professional claims for Global Billing periods.
• Perform contract reimbursement calculations and prepare payer-specific Global Billing coversheets in collaboration with Collections Supervisors and Leads.
• Work with Transplant department coordinators to obtain clinicals (e.g., mobilization and preparative dates for BMT).
• Collaborate with PFS Management and collections team to resolve billing-related denials.
• Monitor held claims for readiness to bill based on the global period.
• All other duties as assigned.

Requirements

• High School diploma or equivalent.
• Minimum three (3) years of experience in hospital billing.
• Payer contract interpretation and understanding.
• Strong knowledge of Transplant billing and collections processes.
• Strong knowledge of the Global Transplant Billing process.
• Proficiency in medical terminology and insurance eligibility/verification.
• Excel proficiency.
• Fire Life Safety Training (LA City) – if no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date (required within LA City only).

Qualifications

• Certified Coding Specialist (CCS) from AHIMA preferred.
• Billing and Coding Certificate preferred.

Pay

The hourly rate range for this position is $30.16 - $47.01. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

About Keck Hospital of USC

Keck Hospital of USC, a 343-bed acute care hospital, provides exceptional and innovative care for complex medical and surgical conditions across a wide range of specialties. The hospital’s world-renowned physicians deliver compassionate, customized, patient-centered care and treat the most acutely ill patients with highly innovative techniques and treatment plans. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies generally not available elsewhere.