This is a UC San Diego Internal Recruitment open to UCSD and UCSD Health System Staff Only
UCSD Layoff from Career Appointment: Apply by 06/14/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 06/16/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.
Incumbent is responsible for securing funding for transplant services. Responsibilities include financial screening, development negotiation of payment or arrangements. Routinely confers with physicians, hospital administrators, contracting, payers and external agencies to develop and coordinate complex negotiations for reimbursement payment rates. Responsible for activities which include compiling patient profiles for substantiation of patient's medical condition to justify specialized services. Produces monthly reports for administrative and clinical leaders responsible for specific programs. Monitors and tracks accounts to ensure that payers and patients have complied with established agreements. Works closely with transplant staff to educate members of contact specifics for individual patients.
Involves patient, third party, government, physician billing and/or collections activities. Provides for coordinated processes, procedures and systems, customer service delivery models and ensuring compliance with internal policy and external agency regulations. Manages insurance reimbursement from third-party billings and government insurance programs. Keeps abreast of the full array of third-party contracts and billing/collections requirements. Incorporates cash posting, accounts receivable management and financial counseling for securing collections of accounts. Investigates highly complex claims, evaluate alternative funding sources for patients in need, and propose procedures and systems in support of efficient workflows and maximization of reimbursement.
Seven (7) years of related experience, education/training, OR a Bachelor's degree in related area plus three (3) years of related experience/training
Experience and proven success in billing and/or collections processes, concepts, systems, and external regulations.
Thorough knowledge of medical terminology and coding.
Working knowledge of healthcare and insurance authorization process.
Excellent telephone etiquette and ability to work with a diverse interdisciplinary team.
Proficiency skilled with Microsoft Office, PowerPoint, Excel, Outlook, etc.
Previous experience working for a transplant unit.
Strong customer service experience.
Strong technical computer skills, such as supporting other staff and helping with troubleshooting.
Must be able to work various hours and locations based on business needs.
Employment is subject to a criminal background check and pre-employment physical
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