Revenue Cycle Specialist - Hybrid

UCSF Health Medical Foundation•Emeryville, CA

16h•$28 - $31•Hybrid

About The Position

The Revenue Cycle Specialist supports multiple facets of the revenue cycle for UBCP practices, including charge entry, Epic work queue oversight and correction, non-coding claim denials, payment posting, refunds, and other revenue cycle functions. The role works collaboratively with Revenue Cycle colleagues and practice partners to produce accurate, timely work that meets established quality and productivity expectations. The position manages claims and account issues across practices, follows up on coverage and payment concerns, processes refunds and correspondence, and provides customer service and pre-collection support for self-pay balances. It also identifies claim trends and recommends reimbursement improvements, while supporting Epic optimization, quality initiatives, compliance requirements, risk mitigation, and other assigned Revenue Cycle duties.

Requirements

High school diploma or equivalent.
Five or more years of healthcare accounts receivable experience, including expertise in unadjudicated claim management, appeals, and pre-collection activities.
Demonstrated experience researching complex account issues, resolving non-coding denials, and working with payers, practices, and patients to support timely reimbursement.
Knowledge of healthcare accounts receivable, insurance billing, revenue cycle compliance, and non-coding denial resolution.
Knowledge of medical terminology and payer rules, regulations, managed care contracts, insurance requirements, and credentialing-related billing requirements.
Strong analytical and problem-solving skills, including the ability to evaluate account activity and develop appropriate solutions.
Proficiency using Epic or another electronic health record or practice management system, Microsoft Excel, Word, Outlook, and web-based applications.
Ability to manage multiple priorities, work independently, and complete assignments accurately within established deadlines.
Excellent verbal and written communication skills, including diplomatic communication and appropriate conflict-resolution techniques.
Ability to establish and maintain effective working relationships with Revenue Cycle colleagues, practice staff, leaders, patients, payers, and other partners.
Ability to maintain professionalism, confidentiality, cultural sensitivity, and respect for patient rights, safety, and ethical standards.
Commitment to teamwork, continuous improvement, service excellence, and organizational quality and performance goals.

Nice To Haves

Additional coursework or training in medical billing, healthcare administration, or a related field.

Responsibilities

Manage claims comprehensively by evaluating payments, denials, registration issues, appeals, and required research for all UBCP practices.
Follow through on accounts when insurance coverage is inactive, ineligible, or cannot be verified.
Review, document, and process patient refunds, including related account adjustments and posting follow-through.
Review and address assigned correspondence within seven calendar days of receipt.
Provide customer service and conduct pre-collection activities for assigned self-pay account balances.
Identify trends in rejected, denied, or unpaid claims and recommend solutions that support timely and accurate reimbursement.
Communicate with practices, payers, patients, and internal partners to resolve account issues and complete assigned work.
Document account activity, corrections, decisions, and process improvements clearly and accurately in the appropriate systems.
Maintain at least 95% accuracy in assigned duties and meet established productivity, quality, and timeliness standards.
Seek guidance when uncertain, share knowledge, request feedback, and partner with team members to achieve departmental goals.
Support Epic optimization, quality initiatives, compliance requirements, risk mitigation, and other Revenue Cycle duties as assigned.