Billing Claims Representative

1 day ago


San Francisco CA United States University of California San Francisco Full time

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, demonstrating 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: UCSF Benefits .

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