Senior Collections Representative

UCSF Health; Emeryville (CA); Hybrid; USD 52,000 - 66,000; Full time

Job summary

UCSF Health in Emeryville, CA seeks a Follow Up Collection Representative to manage inpatient and outpatient accounts with commercial insurance balances. You will compute expected reimbursement, coordinate with payors and hospital departments, and drive accounts to closure.

Ideal candidates have 2+ years in hospital billing, strong analytical skills, and proficiency with Epic, CPT/ICD codes, and MS Office. Some remote work may be possible; on-site presence in Emeryville is required.

Qualifications

• HS Diploma or GED.
• Two or more years of experience working in a hospital billing office environment.
• Excellent knowledge of hospital billing and collections, including packaged claims, stop losses, per diems, carve-outs, contract terms, and CPT, ICD, DRG, HCPCS codes
• Understanding of professional fees
• Strong analytical and organizational skills and verbal & written communication skills
• Proficient computer operation including MS Office, keyboard functions, calculator, copier and fax machine operation
• Proactive and assertive account resolution skills
• Motivated individual with a positive and exceptional work ethic
• Attention to detail and ability to balance assertiveness with compassion for patients and others
• Must be able to work onsite in the Emeryville office, with possibility of remote work from time to time

Responsibilities

• Oversee collections and resolution of all inpatient and outpatient accounts with commercial insurance balances.
• Compute expected reimbursement, recommend legal action when needed, reconcile accounts to closure.
• Analyze information and maintain frequent communication with payors and departmental stakeholders.

Skills

Analytical skills

Organizational skills

Verbal & written communication

Attention to detail

Compassionate patient interaction

Education

HS Diploma or GED

Tools

Epic System

Cirius Billing System

Revenue Cycle Pro

MS Office

Job description

Job Description

Follow Up Collection Representative is responsible for collections and resolution of all inpatient and outpatient accounts with commercial insurance balances across various work queues. Follow up Representatives conduct proactive follow up with payors regarding nonpayment, underpayments or incorrect payments in a stratified manner, calculate expected reimbursement, recommend legal assignment when needed, and reconcile accounts to closure. They utilize multiple databases and applications (Epic System, Cirius Billing System, Revenue Cycle Pro, and multiple payor websites) and frequently contact insurance company representatives, hospital, and clinical departments.

Responsibilities

Oversee collections and resolution of all inpatient and outpatient accounts with commercial insurance balances, compute expected reimbursement, recommend legal action, reconcile accounts to closure, analyze and act on received information, and maintain frequent communication with payors and departmental stakeholders.

Requirements

• HS Diploma or GED
• Two or more years of experience working in a hospital billing office environment
• Excellent knowledge of hospital billing and collections, including packaged claims, stop losses, per diems, carve‑outs, contract terms, and CPT, ICD, DRG, HCPC codes
• Understanding of professional fees
• Strong analytical and organizational skills and verbal & written communication skills
• Proficient computer operation including MS Office, keyboard functions, calculator, copier and fax machine operation
• Proactive and assertive account resolution skills
• Motivated individual with a positive and exceptional work ethic
• Attention to detail and ability to balance assertiveness with compassion for patients and others
• Must be able to work onsite in the Emeryville office, with possibility of remote work from time to time

Preferences

• Medical terminology experience
• ICD, CPT4, HCPCS, DRG coding experience
• Understanding of HIPAA rules and regulations

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

Salary Information

The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. To learn more about the benefits of working at UCSF, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html