Patient Billing and Collection Rep III - 134780

The mission of the Student Health & Well-Being (SHW) cluster is to promote a culture of health and well-being for the student community, deliver equitable high quality innovative services, incorporate inclusive approaches, and celebrate diversity, with the goal of adoption and maintenance of healthy behaviors contributing to the academic success and personal development of all students.

The UC San Diego SHW cluster, which reports through UC San Diego Health System, plays a leadership role in creating a strong and active wellness culture that enables all students to flourish in body, mind and spirit. This includes promotion and the transformation of existing departments, under the oversight of the Executive Director, into a cohesive, trans-disciplinary source of integrated wellness services. The SHW cluster includes the departments of Student Health Services (SHS); Health Promotion Services (HPS); Counseling and Psychological Services (CAPS); Assessment and Analytics (SHAA), Strategic Planning, Innovation and Research (SPIR); and SHW Administration (ADM).

The SHW cluster provides health promotion, counseling and psychological services and primary medical care, including urgent care and support services, to over 43,000 undergraduate, graduate and professional students. Staff consists of physicians, psychiatrists, psychologist, pharmacists, optometrists, nurse practitioners, registered nurses, social workers, radiology technologists, clinical laboratory scientists, medical lab assistants, medical assistants, health educators, administrative and other healthcare professionals. SHW Administration provides full business, financial and infrastructure services, including support for the Executive Director's Office, strategic planning, innovation, research; assessments and analytics; information technology; budget management, resource planning and administration; contracts management; human resources, credentialing/privileging; medical records management, insurance management, patient billing and collections; marketing; and facilities and space.

Administers the student health insurance program and other campus agreements. In collaboration with Insurance/Patient Billing and Collection Team, formulates strategies and administers policies, processes and resources. Acts as a Student Health Insurance Plan (SHIP) Liaison between students and the insurance plan administrators and various healthcare providers. Provides education to students on reconciling insurance statements and bills from external resources. Gathers and analyzes SHIP utilization and expenses based on a variety of sources, including the health plan, third party administrators and SHW.

Investigates highly complex claims, evaluates alternative funding sources for patients in need, and proposes procedures and systems in support of efficient workflows and maximization of reimbursement. Performs the full range of responsibilities within the patient billing and collections function.

Prepares and processes transactions for billing to insurance plans and students. Receives and processes insurance and student payments, monitors and reconciles outstanding charges, and submits charges for Bursar activity, as well as non-Bursar student charge tracking.

Provides assistance and support with special insurance, billing-related projects and implementations, and revenue cycle reviews. Understands and applies medical and insurance terminology.

• Seven years of related experience, education/training, OR a Bachelors degree in related area plus three years of related experience/training.

• Strong knowledge of billing and / or collections processes, concepts, systems and external regulations. Knowledge of medical terminology and coding.

• Strong interpersonal and customer service skills to work effectively with all parties to the billing and collection process, and to productively negotiate terms for successful resolution of outstanding accounts and problems. Demonstrated skill to resolve conflict and handle confrontation with calm, tact and professionalism. Excellent verbal and written communication skills, with the ability to clearly communicate detailed and complicated information.

• Strong computer proficiency in all relevant hardware and software, with a knowledge of spreadsheet and accounting applications, and a variety of specialized billing and insurance systems. Knowledge of business software, specialized applications and EHR systems used in health centers / clinics. Demonstrated experience and competency with standard business equipment, computer technologies and a variety of software including system and networking software, Microsoft Office suite, email and a variety of web-based programs and browsers, with the willingness and ability to update and increase skills as needed to meet the goals of the unit and the division. Demonstrated experience in using electronic medical records and understanding of medical record management.

• Strong organizational skills, with ability to work effectively with frequent interruptions and in a high volume, complex and demanding customer service operation.

• Strong knowledge of the regulations and confidentiality issues involved in the revenue side of medical care, including private and government insurance, self-pay, collections, and reporting and data management. Ability to use discretion, maintain utmost confidentiality and comply with all requirements in use of computer systems and access to any and all patient, student, employee and University data, in electronic and hard copy formats, in compliance with University, state and federal guidelines, including, but not limited to Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA).

• Strong analytical skills to produce comprehensive reports, and identify trends and variations. Ability to coordinate assignments, prioritize responsibilities and foster a professional, positive, team work environment.

• Strong ability to provide recommendations on issues of functionality and operations in billing. Ability to serve as a resource, providing expertise and education to staff and management at all levels.

• Demonstrated ability to actively foster a positive, welcoming climate, and value, include and support all in the UC San Diego community. Demonstrated commitment to diversity, equity and inclusion to foster the best possible working and learning environment.

• Strong ability to use good judgment, instincts and experience in working with student patients, parents, medical personnel and university officials at various levels and in times of emergency and stress.

• Ability to demonstrate the characteristics of professionalism in attire, attitude, conversation, behavior and attentiveness to others; uphold the UCSD Principles of Community and promote a positive and collaborative team environment.

• Demonstrated commitment and ability to acknowledge, advocate and support the efforts to dismantle structural racism and divisive biases based on race, ethnicity, sex, gender identity, age, disability, sexual orientation, religion, and political beliefs.

• Complete all required training assigned by UCOP, UCSD and SHW on a timely basis.

• As appropriate, submit incident reports into the UCSD SHW Incident Report System, RL Datix or current system in use, to report near-misses, process problems or patient or employee injury events. Attend required trainings and refreshers for use and proper steps to follow.

• Epic EMR experience.

• Employment is subject to a criminal background check and pre-employment physical.

• Occasionally required to work overtime, weekend or evening hours.

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

UC San Diego is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

For the University of Californias Affirmative Action Policy please visit: https://policy.ucop.edu/doc/4010393/PPSM-20
For the University of Californias Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

a. "Misconduct" means any violation of the policies or laws governing conduct at the applicant's previous place of employment, including, but not limited to, violations of policies or laws prohibiting sexual harassment, sexual assault, or other forms of harassment, discrimination, dishonesty, or unethical conduct, as defined by the employer. For reference, below are UC's policies addressing some forms of misconduct:

• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace