Patient Biller, Specialty Billing - Remote

About the role

The Patient Biller, Specialty Billing supports UC San Diego Health's mission to deliver outstanding patient care and to create a healthier world. This role requires expertise in insurance billing, including ICD10, CPT, HCPCS, and other coding principles. Responsibilities include resolving claim edits, following up on unpaid claims, tracking denial issues, and working with hospital billing information systems.

Responsibilities

• Resolve claim edits and related errors to produce clean and accurate billing
• Follow up on unpaid claims to determine the root cause/status of delayed payments and track/trend delay issues
• Track/trend and resolve denial issues for assigned payer and/or assigned service line
• Work system-generated claims, edits, record requests, resolve denial issues, and credit balance accounts

Requirements

• HFMA Certified Revenue Cycle Representative (CRCR) within 120 days of hire date
• Minimum of 4 years of current hospital billing and collection experience, including specialty billing functions such as Workers' Compensation, Chronic Dialysis, Radiation Oncology, or related specialty service lines
• Experience with hospital billing and collections, including specialty billing, reimbursement follow up, denial and claim rejection trending and follow up
• Knowledge of medical insurance state and federal rules and regulations related to hospital billing requirements
• Demonstrated ability to apply principles and best practices of customer service and courtesy during all types of customer interactions
• Demonstrated ability to independently apply problem analysis and resolution principles, and situation response guidelines, to appropriately take actions and resolve hospital billing concerns with minimal direction
• Demonstrated ability to communicate and problem-solve issues professionally and effectively with individuals at all levels of the organization
• Demonstrated ability to effectively communicate and escalate unresolved hospital billing concerns to management
• Demonstrated ability to pay attention to details and follow through independently
• Demonstrated ability to communicate effectively – both verbally and in writing
• Demonstrated proficiency in use of Microsoft Office applications (including Outlook, Skype/Lync, Excel, Word)