Under the general supervision and direction of the Billing Manager, the incumbent is responsible for performing a critical function for the Physicians Billing Group (PBG) and its clientele by taking the appropriate billing, collections or Customer Service actions to resolve an account. This requires an understanding of payer guidelines for Medicare, Medi-Cal (and its affiliates), Commercial Insurance, Workers Compensation and various other insurance carriers. Depending on the unit the Collections Representative is assigned to, the incumbent may be required to perform any or all of the following duties: work billing editing error report(s) prior to the submittal of claims to ensure that claims are billed cleanly and free of errors, leading to prompt and maximum pro-fee reimbursement; collecting on insurance and self-pay invoices/accounts with balances as generated and outlined on assigned account receivable work lists, aging reports, system target files and correspondence received and assigned.
Demonstrated skill/experience working with computerized reports or computer systems and/or data bases to abstract relevant billing/collections information. Ability to interact in a professional and diplomatic manner with difficult and/or emotionally charged people. Skill to effectively review and analyze patient account to effectively bill and or collect revenue for services rendered. Possess effective collections techniques and skills. Possess the skill to read and comprehend documents to take appropriate action. Demonstrated skill/experience in professional fee medical collections.
Skill to effectively follow up on accounts receivable (AR), credit or underpaid accounts with insurance carriers and or patients. Well-developed verbal and written communication skills.
Skills to organize and prioritize workload coordinate many assignments simultaneously and meet daily, weekly and or monthly productivity deadlines and standards.
Effective interpersonal and professional communication skills to interact with staff, patients and the general public. Demonstrated ability to work independently with only general supervision. Possess ability and skill to problem solve a wide range of account issues. Demonstrated skill/experience in medical professional fee billing to include Medi-Cal, Medicare, MSI, Champus and commercial insurance carriers. Understanding of capitation and commercial HMO. Demonstrated skill/experience using the CPT and ICD-10 code books for determination of fees and Basic accounting knowledge to understand credits debits and the ability to accurately audit patient ledgers. Possess working knowledge and experience with patient registration and authorization process. Accurate typing and proofreading skills.
Possess knowledge of and skill in using payer websites to assess claim status or to follow-up on collections process. Skill to effectively use PC, MS applications, information data bases, billing systems and relevant payer websites to resolve account billing and/or collections issues. Ability to be flexible to a variety of collection assignments and changing priorities as assigned by management. Filing and record keeping skills. Ability to operate a 10-key calculator.
Ability to work overtime and weekend hours as needed and pre-approved to meet deadlines.
Experience with the GE Billing System.
Bilingual English/Spanish or English/Vietnamese to communicate with patients as needed.
Final candidate subject to background check. As a federal contractor, UC Irvine is required to use E-Verify to confirm the work status of individuals assigned to perform substantial work under certain federal contracts/subcontracts.
The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 categories covered by the UC nondiscrimination policy.
Below are general guidelines on the position's physical, mental, and environmental working conditions. In accordance with applicable state and federal law, UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact Human Resources at (949) 824-0500.
Since 1965, the University of California, Irvine has combined the strengths of a major research university with the bounty of an incomparable Southern California location. UCI's unyielding commitment to rigorous academics, cutting-edge research, and leadership and character development makes the campus a driving force for innovation and discovery that serves our local, national and global communities.