Senior Collections Representative / Self-Pay Billing Office

at  UCSF Health

Under general supervision, the Self-Pay Billing Office (SBO) Customer Service and Self-Pay Collections Representative is responsible for responding to all incoming inquiries from patients, departments, various billing agencies, and other external inquiries. He/she must be ready and able to review the patient’s guarantor billing account holistically across both professional and hospital charges, codes, insurance/patient payments, denials as well as insurance/patient credits. This may extend across the entire enterprise of UCSF Health. The SBO Customer Service and Self-Pay Collections Representative 1 is still developing breadth and depth of billing knowledge. They are developing their expertise to handle standard issues independently but consult with the team lead or manager for more complex or unusual cases.
Requires thorough knowledge of UCSF Health insurance contracts as the unit deals regularly with complex policy and procedural issues that involve contract compliance concerning HMO, PPO, and government payers.
The SBO Customer Service and Self-Pay Collections Representative negotiates prompt payment discounts and set up payment plans according to departmental guidelines at the guarantor level. Applies working knowledge of UCSF Health’s various discount and charity policies.
Recommends accounts for collection agencies assignment or withdrawal. The representative in this team has frequent contact with patients, Patient Financial Services staff, clinic and hospital staff and management, and managers, as well as billing and professional fee and collection services vendors.
Responsible for responding to and following up on patient’s high-dollar outstanding accounts receivable in a courteous and timely manner. Demonstrates the ability to process all customer service inquiries and perform all follow-up aspects with quality, compassion, and assertiveness. Conforms to all UCSF Health, government, and HIPAA policies and procedures.
SBO Customer Service Customer Service and Self-Pay Collections Representatives utilize multiple databases and applications to analyze and take appropriate action on information or documents received. Applications and Databases consist of: Epic, Emdeon eCashiering, MS Outlook, MS Excel, Hospital Rates, Cirius, Imaging, MyQuote, Medi-Cal, Medicare, and other payer websites, SMS/LDA, IDX/LDA
The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on several factors, including your work experience and internal equity within this position classification at UCSF. For positions represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The salary range for this position is $31.80 - $45.62 (Hourly Rate). To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

REQUIRED QUALIFICATIONS

• One or more years of experience in a hospital billing, physician billing, or payor office environment or equivalent combination of education, training, and applicable customer service experience.
• High school graduate or GED certificate.
• Must demonstrate an in-depth understanding of all aspects of billing procedures consistent with those performing insurance follow-up activities in both hospital and professional billing environments.
• Developing knowledge of contracts, insurance billing requirements, UB04 and HCFA 1500 claim forms, Workers’ Compensation, HMOs, PPOs, capitation, Medicare, Medi-Cal, and compliance program regulations.
• Excellent interpersonal, verbal, and written communication skills in a highly-paced, complaint-focused environment.
• Ability to demonstrate cultural sensitivity and respect, courteously, and professionally in all interactions.
• Ability to balance assertiveness with compassion, empathy, and patience for the patient and others.
• Good analytical and organizational skills.
• Must be a motivated individual with a positive and exceptional work ethic.
• Ability to follow directions and written procedures.
• Thorough knowledge of computer operation, keyboard functions, calculator, copier and fax machine operation with standard keyboard skills.
• Good computer software skills (Microsoft Office).
• Thorough understanding of HIPAA rules and regulations.
• Ability to work in Emeryville when required.

PREFERRED QUALIFICATIONS

• Bachelor’s Degree
• Prior work experience in a customer service or call center environment. Working knowledge of electronic billing systems, preferably EPIC.
• Demonstrate a good understanding of all aspects of billing procedures consistent with those performing insurance follow-up activities in both hospital and professional billing environments.
• Working understanding of stop losses, per diems, carve-outs, and other contract terms and conditions.

Please refer the Job description for details