Hospital Revenue Cycle Specialist
4 days ago
Job Summary
The Hospital Billing & Follow Up Rep is a critical role within UC San Diego Health's Revenue Cycle department, supporting the organization's mission to deliver outstanding patient care and create a healthier world.
This position requires a highly skilled professional with extensive knowledge of hospital medical insurance payers and plans, as well as State and Federal rules and regulations related to billing hospital medical insurance claims.
The ideal candidate will have a deep understanding of medical insurance claim appeal submission processes, medical terminology, ICD9, CPT, HCPCS, coding principles, self-pay collections, and mandated charity laws.
Responsibilities include responding to billing inquiries from patients, insurance companies, and internal department team members, identifying and resolving account adjustments, resolving billing edits, and processing account credit balances and insurance refund requests.
This role requires a high level of expertise in hospital billing and collections, with a strong focus on quality and productivity.
Key Responsibilities
- Respond to billing inquiries from patients, insurance companies, and internal department team members
- Identify and resolve account adjustments, resolve billing edits, and process account credit balances and insurance refund requests
- Extensive knowledge of hospital medical insurance payers and plans, State and Federal rules and regulations related to billing hospital medical insurance claims
- Deep understanding of medical insurance claim appeal submission processes, medical terminology, ICD9, CPT, HCPCS, coding principles, self-pay collections, and mandated charity laws
Requirements
- Three (3) years of recent acute care hospital billing and collection experience
- State and Federal rules and regulations related to billing facility medical insurance Claims
- Demonstrated knowledge reviewing/processing hospital claim errors
- Thorough knowledge of UB04 and revenue codes as it pertains to hospital billing
- Extensive knowledge in submission of hospital claims appeals and basic knowledge in medical terminology, ICD9, CPT, HCPCS coding principles
Preferred Qualifications
- Epic Resolute experience
- UB04 experience
- Previous hospital billing experience
- Previous hospital credit balance/refund processing experience
Special Conditions
- 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
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