Rady Children's Hospital-San Diego · 10 hours ago
Billing & Collections Representative II (Casual) - PFS - RCSSD
San Diego, CA
Full-time
Onsite
Entry Level
$23.10/hr - $31.77/hr
2+ years expRady Children's Hospital-San Diego is seeking a Billing & Collections Representative II to manage the resolution of outstanding balances from various payors. This role involves analyzing denials, processing claims, and ensuring compliance with regulatory guidelines.
Health Care
Responsibilities
Resolution of all outstanding balances from all payors
Checking status of unpaid claims by telephone, websites and/or any other means available
Provide all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement
Process claims correctly following contractual arrangements
Accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA)
Review CCI or payor specific coding edits and take necessary steps to send a corrected claim or appeal to payor for reprocessing of claim to overturn denial
Report all problematic payor trends to leadership with specific examples
Forward claim on to leadership for further review and or appropriate resolution of claim
Daily processing of assigned work queues following standards established by Leadership
Selection of activities and documentation on each account in the patient financial record will be completed in accordance with guidelines
Review payor/clearing house rejections and making necessary corrections to ensure claim will be adjudicated
Follow federal, state, and local regulatory collection guidelines as well as department and payor specific billing guidelines
Qualification
Required
H.S. Diploma, GED, or Equivalent
2 Years of Experience
Must possess some medical billing experience
Strong verbal and written communicator
Problem-solver
Master negotiator
Emotional Intelligence
Attention to detail
Preferred
3 Years of Experience
EPIC experience a plus
Company
Rady Children's Hospital-San Diego
Ranked as one of the 10 best children’s hospitals in the nation by U.S.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$0.4MKey Investors
Hyundai Hope On Wheels
2024-08-28Grant· $0.4M
Leadership Team
Patrick Frias
Founder, CEO & President
Recent News
Orange County Business Journal
2025-11-18
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