The Government, Commercial, Contract, and Managed Care (CCMC) Units are responsible for the accounts receivable, billing, and follow-up of all government or commercial, contract, and managed care payers. The units deal regularly with complex policy and procedural issues that involve contract compliance concerning Medicare, Medi-Cal, CCS, HMO, and PPO payers. It is the units’ responsibility to communicate and coordinate throughout various UCSF Medical Center departments, including the UCSF billin... more details
The Government, Commercial, Contract, and Managed Care (CCMC) Units are responsible for the accounts receivable, billing, and follow-up of all government or commercial, contract, and managed care payers. The units deal regularly with complex policy and procedural issues that involve contract compliance concerning Medicare, Medi-Cal, CCS, HMO, and PPO payers. It is the units’ responsibility to communicate and coordinate throughout various UCSF Medical Center departments, including the UCSF billing agents to ensure the quality of the university’s billing process.
Within these units, the Follow-Up Representatives are responsible for billing and follow-up of government, commercial, contract and/or managed care accounts receivables for MGBS clients. The incumbent demonstrates the ability to perform all aspects of billing and follow-up with quality. The incumbent’s main task is to resolve all outstanding insurance accounts through constant communication with the payers (by phone or via web access), other MGBS units, UCSF clinical departments and billing agents.
When resolving the accounts receivables; the Follow-Up Representative must adhere to the MGBS SRG (Situation Response Guide) to ensure consistency with the follow-up and documentation processes and to maintain good quality work. The Follow-up Representative must meet minimum productivity standards and quality expectations of their units. The Follow-up Representative must attend and be engaged in unit and team meetings aimed at increasing knowledge. The incumbent will utilize web-based tools, including payor websites and the RMS website before calling payors. The incumbent will conform to all UCSF, MGBS, government, and HIPAA policies and procedures.
Prior working knowledge of the EPIC (Apex) system, especially PB or HB Insurance Follow up Module(s).
Certified Procedural Coder (CPC)
High School Graduate or GED equivalency
Associates or Bachelor’s Degree
High School Diploma or GED
One year or more years of Insurance Follow-up experience.
Experience with Denials Management
Demonstrate the Ability to communicate effectively (orally and written).
Knowledge of CPT and ICD-10Experience with MS EXCEL and OUTLOOK.
Ability to work independently or as needed with a team.
Ability to meet productivity and quality standards.
Demonstrates a positive attitude and excellent customer service skills.
Proven ability to coach and mentor staff for optimal results
Ability to set priorities, goals, and objectives
Demonstrate the ability to perform all aspects of billing and follow-up with superior quality.
Effective Time Management and Ability to Meet Deadlines
Excellent Attendance Record.
The ability to work in our Emeryville office when needed.
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