Collections Representative

TEP-Health Employees

Temporary Employment

87880BR

Job Summary

The anticipated duration of this assignment is approximately five months and includes optional medical coverage, holiday pay, and sick leave accrual. The first two weeks will require on-site training in Emeryville; thereafter, on-site attendance will be required as needed.

Position Summary

Under general supervision, the Self-Pay Billing Office (SBO) Customer Service and Self-Pay Collections Representative I responds to inquiries from patients, UCSF Health departments, billing agencies, and other external partners. The role involves reviewing guarantor billing accounts across both professional and hospital charges, including coding, payments, denials, and credits, which may span the UCSF Health enterprise.

At this level, the representative is developing billing expertise, independently handling standard issues while consulting with a team lead or manager on complex or unusual cases.

This role requires a working knowledge of UCSF Health insurance contracts and policies, as the unit regularly addresses complex compliance issues involving HMO, PPO, and government payers. The representative negotiates prompt-pay discounts, establishes payment plans, applies UCSF Health discount and charity policies, and recommends accounts for collection agency assignment or withdrawal.

The position involves frequent interaction with patients, Patient Financial Services staff, clinic and hospital teams, management, and external vendors. All activities are performed in accordance with UCSF Health, government, and HIPAA policies.

• Respond to patient, department, and external inquiries, resolving billing, insurance, pricing, appeals, missing payment, and quality-of-care issues. Review guarantor accounts holistically and escalate complex issues.

• Answer incoming calls via ACD system, triage difficult cases, and maintain documentation in SBO note types to ensure continuity and an audit trail.

• Navigate Epic and MyChart Billing with patients, providing clear explanations, step-by-step troubleshooting, and guidance on next steps for complex issues.

• Determine appropriate payer classification (e.g., government, non-government, HMO, PPO, Workers' Compensation, research/study) and seek guidance on unusual cases.

• Verify and update guarantor and patient demographics and insurance information for hospital and professional accounts.

• Secure patient payments, including credit card processing via Bluefin keypads and MyChart QuickPay, and maintain assigned work queues, including RFIs to resolve charging and coding questions.

• Determine financial assistance eligibility, apply self-pay discounts, charity care, and contractual adjustments, and establish payment plans in accordance with guidelines.

• Prepare accounts for transfer to collection agencies, research missing payments, and process payment transfers, credits, and refunds with supporting documentation.

• Utilize multiple systems and databases, including Epic, Emdeon eCashiering, MS Outlook, MS Excel, Hospital Rates, Cirius, Imaging, MyQuote, Medi-Cal, Medicare, IDX/LDA, SMS/LDA, and payer websites, to support follow-up, insurance verification, and account management.

• Provide backup support to the Correspondence Unit as needed and notify management of issues affecting performance or improvement initiatives.

• Attend required department, unit, and other meetings.

The final salary and offer components are subject to additional approvals based on UC policy.
To see the salary range for this position (we recommend that you make a note of the job code and use that to look up): TCS Non-Academic Titles Search (https://tcs.ucop.edu/non-academic-titles)
Please note: An offer will take into consideration the experience of the final candidate AND the current salary level of individuals working at UCSF in a similar role.
For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range.
To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

Department Description

UCSF's Temporary Employment Program (TEP) recruits and hires temporary employees for immediate clerical and technical support services to UCSF Departments and various off-campus locations. UCSF departments deploy temporary employees to work on special projects, fill in for regular employees who are on vacation or leave, or to temporarily fill a vacant position during recruitment. Frequently temporary employees become successful candidates for career and limited appointment positions.

Required Qualifications

• Minimum of 1-2 years of experience in hospital billing, physician billing, or a payor office environment, or an equivalent combination of education, training, and applicable customer service experience.
• Strong experience with EPIC/APeX.
• High school diploma or GED certificate.
• Demonstrated understanding of billing procedures, including insurance follow-up activities, in both hospital and professional billing environments.
• Developing knowledge of contracts, insurance billing requirements, UB04 and HCFA 1500 claim forms, Workers' Compensation, HMOs, PPOs, capitation, Medicare, Medi-Cal, and compliance regulations.
• Excellent interpersonal, verbal, and written communication skills in a fast-paced, complaint-focused environment.
• Ability to demonstrate cultural sensitivity and maintain a respectful, courteous, and professional manner in all interactions.
• Ability to balance assertiveness with compassion, empathy, and patience when interacting with patients and others.
• Strong analytical and organizational skills.
• Self-motivated with a positive attitude and exceptional work ethic.
• Ability to follow directions and written procedures accurately.
• Proficient with computer operations
• Computer software proficiency, including Microsoft Office applications and email.
• Thorough understanding of HIPAA rules and regulations.

Preferred Qualifications

• Bachelor's degree.

• Prior experience in a customer service or call center environment.

• Solid understanding of billing procedures, including insurance follow-up activities, in both hospital and professional billing environments.

• Working knowledge of stop losses, per diems, carve-outs, and other contract terms and conditions.

About UCSF

The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world's leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

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.

Organization

TEP

Job Code and Payroll Title

004621 COLL REPR SR

Job Category

Accounting / Finance, Administrative Support, Support Services, Temporary Employment

Bargaining Unit

Teamsters Local 2010 - Clerical and Allied Services Unit (CX)

Employee Class

Temporary Employment

Percentage

100%

Location

Emeryville, CA

Campus

Emeryville

Work Style

Flexible

Shift

Days

Shift Length

8 Hours