Denials Sr. Billing & Follow Up Rep - Remote
About the position
The Denials Senior Billing and Follow Up Representative at UC San Diego Health's Revenue Cycle department plays a crucial role in ensuring accurate hospital billing and follow-up processes. This position is responsible for resolving claim edits, tracking denied claims, and addressing denial issues to support the revenue cycle while adhering to applicable standards and regulations. The role requires extensive knowledge of insurance billing, coding principles, and medical terminology, as well as strong communication skills to collaborate effectively with various stakeholders.
Responsibilities
Perform hospital billing and follow-up functions in support of the revenue cycle.
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Resolve claim edits and related errors to produce clean and accurate billing.
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Follow up on denied claims to determine the root cause and status of denied payments.
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Track and trend denial issues for assigned payers and service lines.
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Work on system-generated claims, edits, and record requests.
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Resolve denial issues and credit balance accounts.
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Provide job shadow knowledge sharing with team members as appropriate.
Requirements
Minimum of 4 years of hospital billing and collection experience.
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Experience with hospital billing and collections, including specialty billing and reimbursement follow-up.
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Extensive knowledge in insurance claims appeals and coding guidelines.
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Expert knowledge of medical insurance and State and Federal rules related to billing insurance claims.
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Knowledge of accounting and cash handling principles and various billing documents.
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Excellent verbal and written communication skills.
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Expertise using Excel, Word, and Outlook.
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Self-starter who is accountable and requires minimal direction.
Nice-to-haves
College level coursework in billing certification, medical terminology, health, finance, or other relevant subjects.
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5 or more years of experience in hospital billing and collections.
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Experience with both hospital and professional services revenue cycle.
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Experience working in Epic Hospital Billing Functionality.
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Experience in an academic hospital setting.
Benefits
Remote work flexibility
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Challenging career opportunities
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Supportive team environment
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Commitment to quality and continuous improvement
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