Job SummaryThe Government, Commercial, Contract and Managed Care (CCMC) Units are responsible for the accounts receivable, billing, and follow-up of all government or commercial, contract and managed care payers. The units deal regularly with complex policy and procedural issues that involve contract compliance with regard to Medicare, Medi-Cal, CCS, HMO and PPO payers. It is the units’ responsibilities to communicate and to coordinate throughout various UCSF Medical Center departments, including the UCSF billing agents to ensure the quality of the university’s billing process. Within these units, the A/R - Billing - Follow-up Representatives (Rep.'s) are responsible for billing and follow-up of government, commercial, contract and/or managed care accounts receivables for MGBS clients to include the following:Demonstrates the ability to perform all aspect of billing and follow-up with quality. Resolve all outstanding insurance accounts through constant communication with the payers (by phone or via web access), other MGBS units, UCSF clinical departments and billing agents. When resolving the accounts receivables; the Rep.'s are required to:Adhere to the MGBS SRG (Situation Response Guide) to ensure consistency with the follow-up and documentation processes and to maintain good quality work. Meet minimum productivity standards and quality expectations of their units. Attend and be engaged in unit and team meetings aimed at increasing knowledge. Utilize web based tools, including payor websites and the RMS website prior to calling payors and conform to all UCSF, MGBS, government and HIPAA policies and procedures.The final salary and offer components are subject to additional approvals based on UC policy. 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 $33.14 - $47.52 (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 Medical Group Business Services (MGBS) is responsible for the professional fee billing and collections for approximately 25 divisions in the School of Medicine. MGBS collects approximately $1B annually and takes ownership for continuing to find ways for the Divisions to ensure charges are captured and increase payments.Required QualificationsHigh School Diploma or GEDOne or more years of Insurance Follow up experience. Experience with Denials ManagementExperience with MS Office. Knowledge of CPT and ICD-10Demonstrate the ability to perform all aspects of billing and follow-up with superior quality. Ability to set and meet priorities, goals and objectives.Effective Time Management and Ability to Meet DeadlinesAbility to work independently or as needed with a team. Ability to meet productivity and quality standards. Demonstrates a positive attitude and excellent customer service skills. Proven ability to coach and mentor staff for optimal results.Excellent Attendance Record. Excellent communication skills (verbal & written).The ability to work on-site in our Emeryville office when needed.Preferred QualificationsPrior working knowledge of the EPIC (Apex) system, especially PB or HB Insurance Follow up Module(s). Certified Procedural Coder (CPC)Associate's Degree or higher About UCSFAt 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 ValuesUCSF 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.
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