This is a full time career position located in UC Davis Health System, Patient Care Network Billing, in Sacramento. Working hours are Monday through Friday 8:00 a.m. to 5:00 p.m. This classification is not represented by a union.
--Recent significant experience as a supervisor or equivalent role in one or more of the following areas: outpatient medical billing operations, or medical clinic registration/front office operations
--Significant experience using Epic Resolute or equivalent billing system to effectively work, Claim Edit, Credit and Follow-up PB work queues as well as the knowledge to audit, trace and adjust accounts using this system
--Excellent leadership and supervisory skills
--Ability to clearly communicate verbally, in writing or in person
--Effective training skills in conjunction with experience and knowledge of the Epic Resolute PB follow-up or other equivalent billing system, and other aspects of the revenue cycle
--Knowledge of Medicare, Medi-Cal, PPO and HMO billing practices for outpatient primary care clinics. Must have significant work experience with outside payor requirements and procedures related to billing and following up open balance accounts
--Knowledge of CPT-4, HCPCS and ICD-9, ICD-10 coding appropriate for primary care, OB-GYN, radiology, and selected specialty billing
--Problem solving and judgment skills to research, analyze and resolve or recommend alternatives to problem situations
--Ability to effectively manage a heavy workload, delegate work to staff and handle pressure of deadlines
--Knowledge and experience with Payment and Denial posting, preferably in the Epic Enterprise Payment Posting Module
--Knowledge and experience of other medical or health systems associated with our revenue cycle follow-up
--Knowledge and experience in the Medicare and Medi-Cal provider enrollment process
--Knowledge of the UCDHS provider credentialing system Responsibilities primary and secondary billing claims for all PCN medical services, is responsible for all third-party A/R follow-up, and is responsible for resolving PCN credit balance accounts. The Patient Biller V Supervisor is responsible for one team of PCN Billing Department Patient Billers assigned to A/R follow-up. The primary focus of each PCN Billing team is to follow-up on all payor reimbursement denials, correcting billing information that is in error and appealing all unpaid but correctable claims. Each team is responsible for the A/R follow-up of a specific group of payors, e.g. Medicare, Medi-Cal, Commercial/PPO, W/Comp, CHDP, or others. The Supervisor is responsible for directing staff members relative to the billing (collection) policies and performance guidelines specified by the Manager of PCN Billing.
Special Requirements --THIS POSITION MAY BE SUBJECT TO A CRIMINAL BACKGROUND INVESTIGATION, DRUG SCREEN, LIVE SCAN FINGERPRINTING, MEDICAL EVALUATION CLEARANCE, AND FUNCTIONAL CAPACITY ASSESSMENT.