Revenue Cycle Specialist

Position Summary

Supports multiple facets of the revenue cycle, including charge entry, Epic work queue oversight and correction, non-coding claim denials, payment posting, refunds, and other revenue cycle functions for UBCP practices. Works collaboratively with Revenue Cycle colleagues and practice partners to produce accurate, timely work that meets established quality and productivity expectations.

Essential Duties and Responsibilities

• Manage claims comprehensively by evaluating payments, denials, registration issues, appeals, and required research for all UBCP practices.
• Follow through on accounts when insurance coverage is inactive, ineligible, or cannot be verified.
• Review, document, and process patient refunds, including related account adjustments and posting follow-through.
• Review and address assigned correspondence within seven calendar days of receipt.
• Provide customer service and conduct pre-collection activities for assigned self-pay account balances.
• Identify trends in rejected, denied, or unpaid claims and recommend solutions that support timely and accurate reimbursement.
• Communicate directly with practices, payers, patients, and internal partners as needed to resolve account issues and complete assigned work.
• Document account activity, corrections, decisions, and process improvements clearly and accurately in the appropriate systems.
• Maintain at least 95% accuracy in assigned job duties and ensure work meets established productivity, quality, and timeliness standards.
• Pause and seek guidance when uncertain; share knowledge, request feedback, and partner with team members to achieve departmental goals.
• Support Epic optimization, quality initiatives, compliance requirements, risk mitigation, and other Revenue Cycle duties as assigned.

Knowledge, Skills, and Abilities

• Knowledge of healthcare accounts receivable, insurance billing, revenue cycle compliance, and non-coding denial resolution.
• Knowledge of medical terminology and payer rules, regulations, managed care contracts, insurance requirements, and credentialing-related billing requirements.
• Strong analytical and problem-solving skills, with the ability to evaluate account activity and develop appropriate solutions.
• Proficiency using Epic or another electronic health record or practice management system, along with Microsoft Excel, Word, Outlook, and web-based applications.
• Ability to manage multiple priorities, work independently, and complete assignments accurately and within established deadlines.
• Excellent verbal and written communication skills, including the ability to communicate diplomatically and use appropriate conflict-resolution techniques.
• Ability to establish and maintain effective working relationships with Revenue Cycle colleagues, practice staff, leaders, patients, payers, and other partners.
• Ability to maintain professionalism, confidentiality, cultural sensitivity, and respect for patient rights, safety, and ethical standards.
• Commitment to teamwork, continuous improvement, service excellence, and organizational quality and performance goals.

Education

• High school diploma or equivalent required.
• Additional coursework or training in medical billing, healthcare administration, or a related field preferred.

Typical Experience

• Five or more years of healthcare accounts receivable experience, including expertise in unadjudicated claim management, appeals, and pre-collection activities.
• Demonstrated experience researching complex account issues, resolving non-coding denials, and working with payers, practices, and patients to support timely reimbursement.

Pay Range: $28.00 - $31.00 per hour

Equal Employment Opportunity

UCSF Health Medical Foundation is an equal opportunity employer. In accordance with applicable law, we prohibit discrimination against any applicant or employee based on any legally-recognized basis, including, but not limited to: veteran status, uniformed service member status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy (including childbirth, lactation and related medical conditions), national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other consideration protected by federal, state or local law. Our commitment to equal opportunity employment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee, including supervisors and co-workers. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs.