Transplant Billing & Follow Up Rep - Hybrid

Overview

6256 Greenwich Dr, San Diego, CA, 92122

Transplant Billing & Follow Up Rep - Hybrid Filing Deadline: Fri 9/19/2025

This position will work a hybrid schedule which includes a combination of onsite at Greenwich Drive (San Diego, CA) and remote work. Onsite 3 days a week. This position will remain open until filled.

UC San Diego values equity, diversity, and inclusion. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.

Pay Transparency

Annual Full Pay Range: $61,116 - $75,982 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $29.27 - $36.39

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs.

DESCRIPTION

UC San Diego Health is seeking a skilled and motivated Billing & Collections Representative to join our large-scale hospital billing operations team. This role focuses on Solid Organ Transplant, Bone Marrow Transplant (BMT), and CAR T billing and follow-up, one of the most specialized and complex areas of hospital revenue cycle. The successful candidate will demonstrate strong billing and collections expertise, attention to detail, and the ability to work claims from start to finish across government and commercial payors.

Key Responsibilities

• Process Hospital Billing (HB) and Professional Billing (PB) claims for Solid Organ, BMT, and CAR T services across pre-, intra-, and post-transplant phases.
• Prepare and submit clean claims with all required documentation, ensuring accurate account linking and transplant bundle billing.
• Conduct account follow-up and collections: monitor outstanding balances, resolve denials, submit appeals, and escalate unresolved claims as needed.
• Review account trial balances (ATBs), hospital account records (HARs), and authorizations in Epic to ensure billing compliance.
• Collaborate with internal teams including Authorization, Financial Coordinators, and Revenue Integrity to resolve issues and secure payment.
• Maintain compliance with payer rules, state/federal regulations, and UC San Diego Health policies.

Key Skills

• Billing & Collections Expertise: End-to-end claims management and denial resolution.
• Technical Proficiency: Epic HB/PB billing and transplant account structures.
• Analytical Ability: Review accounts, identify errors, and correct billing issues proactively.
• Collaboration: Partner with financial coordinators, clinicians, and payer representatives.
• Professional Communication: Confidently handle payer interactions and escalations.

MINIMUM QUALIFICATIONS

• Three (3) years of recent acute care hospital billing and collection experience.
• Knowledge of medical insurance and State and Federal rules and regulations related to billing Insurance Claims.
• Extensive knowledge in Insurance claims appeals, and range of knowledge in ICD-10, CPT, HCPCS coding principles.
• Knowledge in self-pay collections.
• Knowledge of UB04 and revenue codes as it pertains to billing.

PREFERRED QUALIFICATIONS

• Certification in billing/coding (e.g., CPC, CPB, HB).
• Strong working knowledge of Epic billing systems (HAR, ATB, Auth/Cert).
• Experience with government and commercial payors.
• Proven ability to resolve complex denials and secure payments on high-dollar accounts.
• Prior transplant billing experience (Solid Organ, BMT, CAR T) in an academic medical center or large hospital system.
• Knowledge of transplant billing phases:
• Pre-Transplant: evaluation, testing, clearance, and how services are reimbursed or bundled.
• Inpatient/Transplant Event: identifying anastomosis date, global case period start, and submitting bundle claims with required payer documentation.
• Post-Transplant: billing re-admissions, outpatient follow-up, labs, and bundled care per payer agreement.
• Experience managing single-bundle and two-part bundle claims
• Familiarity with payer transplant networks and agreements across government and commercial payors
• Ability to review and prepare Billing Summaries, Itemized Statements, Organ Acquisition and Perfusion Invoices, and ensure proper inclusion/exclusion of services.
• Experience collaborating with Transplant Financial Coordinators (TFCs), Central Authorization Teams (CATs), and clinical staff to align financial clearance, authorizations, and claim submissions.
• Strong understanding of Epic billing functionality related to transplant (HAR, ATB, Auth/Cert, EOC linking).
• Demonstrated success in appeals and follow-up for high-dollar, complex transplant claims.

SPECIAL CONDITIONS

• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and pre-employment physical.

Special Selection Applicants : Apply by 09/19/25. Eligible Special Selection clients should contact their Disability Counselor for assistance.

UCSD Layoff from Career Appointment : Apply by 09/10/25 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.

SPECIAL NOTES

Pay transparency and health system policies apply. If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements. Life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, with facilities including two university hospitals and numerous clinics. We invite you to join our team!

EEO Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

For the University of California's Anti-Discrimination Policy, please visit:

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.