"Collections Representative"

The anticipated duration of this assignment is approximately five months and includes optional medical coverage, holiday pay, and sick leave accrual. The first two weeks will require on-site training in Emeryville; thereafter, on-site attendance will be required as needed.

Position Summary

Under general supervision, the Self-Pay Billing Office (SBO) Customer Service and Self-Pay Collections Representative I responds to inquiries from patients, UCSF Health departments, billing agencies, and other external partners. The role involves reviewing guarantor billing accounts across both professional and hospital charges, including coding, payments, denials, and credits, which may span the UCSF Health enterprise.

At this level, the representative is developing billing expertise, independently handling standard issues while consulting with a team lead or manager on complex or unusual cases.

Knowledge & Scope

This role requires a working knowledge of UCSF Health insurance contracts and policies, as the unit regularly addresses complex compliance issues involving HMO, PPO, and government payers. The representative negotiates prompt-pay discounts, establishes payment plans, applies UCSF Health discount and charity policies, and recommends accounts for collection agency assignment or withdrawal.

The position involves frequent interaction with patients, Patient Financial Services staff, clinic and hospital teams, management, and external vendors. All activities are performed in accordance with UCSF Health, government, and HIPAA policies.

Core Responsibilities

• Respond to patient, department, and external inquiries, resolving billing, insurance, pricing, appeals, missing payment, and quality-of-care issues. Review guarantor accounts holistically and escalate complex issues.
• Answer incoming calls via ACD system, triage difficult cases, and maintain documentation in SBO note types to ensure continuity and an audit trail.
• Navigate Epic and MyChart Billing with patients, providing clear explanations, step-by-step troubleshooting, and guidance on next steps for complex issues.
• Determine appropriate payer classification (e.g., government, non-government, HMO, PPO, Workers' Compensation, research/study) and seek guidance on unusual cases.
• Verify and update guarantor and patient demographics and insurance information for hospital and professional accounts.
• Secure patient payments, including credit card processing via Bluefin keypads and MyChart QuickPay, and maintain assigned work queues, including RFIs to resolve charging and coding questions.
• Determine financial assistance eligibility, apply self-pay discounts, charity care, and contractual adjustments, and establish payment plans in accordance with guidelines.
• Prepare accounts for transfer to collection agencies, research missing payments, and process payment transfers, credits, and refunds with supporting documentation.
• Utilize multiple systems and databases, including Epic, Emdeon eCashiering, MS Outlook, MS Excel, Hospital Rates, Cirius, Imaging, MyQuote, Medi-Cal, Medicare, IDX/LDA, SMS/LDA, and payer websites, to support follow-up, insurance verification, and account management.
• Provide backup support to the Correspondence Unit as needed and notify management of issues affecting performance or improvement initiatives.
• Attend required department, unit, and other meetings.

The final salary and offer components are subject to additional approvals based on UC policy. To see the salary range for this position (we recommend that you make a note of the job code and use that to look up): TCS Non-Academic Titles Search

Please note: An offer will take into consideration the experience of the final candidate AND the current salary level of individuals working at UCSF in a similar role. For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range. To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html