Revenue Cycle Specialist - Hybrid and Remote

UCSF Health Medical Foundation•Emeryville, CA

22h•$28 - $31•Hybrid

About The Position

UCSF Benioff Children's Physicians (UBCP) is a multispecialty physician foundation, and an associated clinically integrated network. Our primary goal is to foster physician collaboration to deliver the most advanced maternal and pediatric care throughout Northern California and beyond. We have Pediatric, Adult Health, OB-GYN, Allergy & Asthma clinics located throughout the San Francisco Bay Area. POSITION SUMMARY: Responsible for varying facets of the revenue cycle processes. These processes can include charge entry, EPIC work queue oversight and correction, claims denials due to non-coding issues, payment posting, refunds and other revenue cycle assistance to the various practices within UBCP. Works collaboratively with Revenue Cycle colleagues to ensure provision of work products that meet quality and quantity expectations established by the organization.

Requirements

Computer (Explorer, Excel, Word, Outlook, EPIC (or other EHR software).
Multi-task and work independently.
Good communication skills both verbal and written.
High School/GED
Knowledge of insurance billing and compliance with a high level of problem solving skills.
Medical terminology, rules, and regulations relating to the Revenue Cycle.
Understanding of managed care contracts, insurance and credentialing compliance
5+ years of healthcare accounts receivable experience with expertise in un-adjudicated claim management, appeals and pre-collections.

Nice To Haves

Possess the ability to analyze situations and strategize solutions.
Excellent verbal and written communication skills.
Ability to demonstrate diplomacy in communication and use conflict resolution techniques.
Engages in teamwork and collegial collaboration among all team members.
Maintains positive working relationships with UBCP colleagues, and others.
Ensures work product meets defined quality, quantity and timeliness expectations.
Monitors and addresses potential risk management and quality issues in a timely manner.
Addresses quality and quantity requirements in an effective and timely manner.
Maintains standards of service, productivity, safety, and security.
Ensure Electronic Health Record (E.H.R.) optimization within the organization.
Participate in initiatives to achieve performance on quality metrics set forth by the organization.

Responsibilities

Comprehensive claims management to include evaluation of payments, denials, registration, appeals and research as appropriate for all UBCP practices.
Conducts appropriate follow through when insurance coverage is not eligible.
Review, document and execute patient refunds with adjustment posting follow through.
Addresses all correspondence assigned within seven days of receipt.
Customer service and pre-collection of self-pay account balances as assigned
Help to identify trends and provide possible solutions to reduce rejected and/or unpaid claims.
Provide direct communication with practices as necessary to complete job duties.
Documents in a clear manner to support all changes and process improvement.
Quality responsibilities: i. Maintain 95% accuracy of job duties. ii. Stops when uncertain and takes the time to resolve situations. iii. Shares and seeks knowledge and provides feedback to others. iv. Partners with all team members to achieve goals.
Performs other duties as assigned.