Patient Biller II - 140681

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. 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.

Responsible for providing overall support to the Medicare/TRICARE billing team, the team Supervisor, and the team Manager. Sorts, counts, and logs all incoming correspondence, including all Medicare RAC audits and refund notifications, forwards batches of correspondence, mail, faxes and rejected claims to the correct billers on a weekly basis. Retrieves and distributes mail daily, works Auth/Reg/Med Recs denials, scan files for retrieval. Maintains/files for all financial documents, medical record documents, audit documents, and Advanced Beneficiary Notices. Maintains and updates Medicare CCI manuals and Medicare/TRICARE issue binders. Request and retrieves medical documentation as requested by the team and maintains an accurate digital storage system for storing the documents for biller access.

The PB II 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 as they pertain to Auth/Reg/Med Recs denials.

• High School diploma, GED or equivalent combination of education and experience.

• Proficiency with MS Office Products (Mail, Excel & Word). Ability to type at least 25 wpm.

• Must maintain strict confidentiality at all times. Must be detailed oriented, organized, and possess excellent time management skills.

• One (1) year of relevant experience (billing, coding & PB/pro-fee) or successful completion of a billing or coding certificate.

• PB/pro-fee experience.

• Epic experience.

• Revenue Cycle experience.

• Basic 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 payor communications in order to resolve outstanding bills.

• Customer focused mindset. Detail-oriented, organized, and possess excellent written and verbal communication skills.

• Self-motivated and comfortable working independently as well as collaborating as part of a team to accomplish common goals.

• 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.