Billing Claims Representative
Medical Group Business Services Job Summary The Billing/Claims Unit is responsible for billing hard copy claims working in the Claims Edit Work queues and following up on return mail. The unit deals regularly with complex policy and procedural issues that involve contract compliance with HMO and PPO payers. It is the unit's responsibility to communicate and coordinate throughout various UCSF Medical Center departments, including the UCSF billing agents to ensure the quality of the university's billing process.
Within this unit, the Billing Claims Representative is responsible for the timely submission of hard copy claims as well as gathering all forms and information required for primary and secondary billing. The incumbent analyzes and reviews claims for general accuracy and completeness. The incumbent demonstrates the ability to perform all aspects of billing with quality. The incumbent will also conform to all UCSF, MGBS, government, and HIPAA policies and procedures.
The understanding and working knowledge of the UCSF clients, as well as the government payers in an ever-changing environment is a challenge. The government rules and regulations are very stringent and we must adhere to them as well as interpret them for the departments and providers. The compliance aspect of billing and follow-up while continuing to achieve the highest reimbursement rate possible is complicated.
A Billing Claims Representative has the ultimate responsibility to involve in-depth review and analysis of patient accounts so that each charge can be accurately and timely posted. As a unit, we strive to improve our analytical skills and understanding of complex healthcare-related procedures. In addition, we are flexible and adaptable to the change in computing systems and utilize web-based tools, including payor websites.
Based on UC policy, the final salary and offer components are subject to additional approvals. Your placement within the salary range is dependent on several factors, including your work experience and internal equity within this position classification at UCSF. For positions represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The salary range for this position is $30.25 to $43.30 (Hourly Rate). 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 Medical Group Business Services (MGBS) is responsible for the Professional Fee Billing and Insurance Payer Collections for approximately 30 divisions in the School of Medicine (SOM) and Out-Patient Clinics. MGBS manages an average of $2.2B in charges with average collections totaling $897M. In addition to billing and operations management, MGBS takes ownership for continuing to identify revenue cycle optimization opportunities across all PB Revenue Cycle Stakeholders that result in increased payments year over year. Required Qualifications
- High School Diploma or GED.
- One or more years of experience in a professional fee billing office or related health-care experience.
- Ability to work in a changing environment and handle multiple tasks efficiently
- Good organizational interpersonal and verbal & written communication skills
- Knowledge of computer operations (i.e. typing, Microsoft Word, Excel)
- Ability to work independently and in Emeryville when required.
Preferred Qualifications
- Knowledge of CPT and ICD-9, ICD.10 Coding.
- Solid understanding of the billing requirements of each major payor.
- Medical terminology experience.
About UCSF At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.
Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents. 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 San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Job Code and Payroll Title 004722 BLANK AST 3 Job Category Accounting / Finance, Administrative Support, Financial, Support Services Bargaining Unit Teamsters Local 2010 - Clerical and Allied Services Unit (CX) Additional Shift Details M-F |
University of California - San Francisco Campus and Health
Nov 19, 2024