Billing & Collections Representative II - PFS - RCSSD

Rady Children's Hospital

San Diego, CA

JOB DETAILS
SALARY
$23.10–$31.77 Per Hour
SKILLS
Adjudication, Analysis Skills, Background Investigation, Behavioral Health, Billing, Claims Management, Claims Processing, Collections Regulations, Credit and Collections, Customer Support/Service, Detail Oriented, Direct Email, Documentation, EEO Regulations, Email Marketing, Facebook, Federal Laws and Regulations, Food Services, Genetics, Healthcare, Hospital, Information Technology & Information Systems, Insurance Documentation, Leadership, Life Insurance, LinkedIn, Managed Care, Marketing Communications, Medi-Cal, Medical Billing, Medical Records, Mentoring, Military, Negotiation Skills, Newsletter, Nonprofit, Nursing, Oncology, Patient Care, Patient Care Denials, Pediatrics, Presentation/Verbal Skills, Problem Solving Skills, Reimbursement, Respiratory Therapy, Short Messaging Service (SMS), Standards of Care, State Laws and Regulations, Time Management, Trend Analysis, Writing Skills, YouTube
LOCATION
San Diego, CA
POSTED
30+ days ago

Billing & Collections Representative II - PFS - RCSSD Jobs and Careers at Rady Children's in San Diego

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Billing & Collections Representative II - PFS - RCSSD

San Diego, California

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Job ID 18813

Date posted 05/07/2026

Schedule Full-Time

Shift Day

Department PFS - RCSSD

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JOB SUMMARY:

Under the direction of the Manager Professional Billing & Coding, the Billing & Collections Representative II (BCII) is responsible for the resolution of all outstanding balances from all payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims. This position is responsible checking status of unpaid claims by telephone, websites and/or any other means available in an efficient and timely manner. BCII is expected to provide all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF) has with each Payor. This incumbent is expected to accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA). As well, they are to 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. They are to report all problematic payor trends to leadership with specific examples. If BCII has exhausted all efforts with payor to resolve a denial following our guidelines, they will

forward claim on to leadership for further review and or appropriate resolution of claim. Incumbent is responsible for 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. BCII will review payor/clearing house rejections and making necessary corrections to ensure claim will be adjudicated. Incumbent is expected to follow federal, state, and local regulatory collection guidelines as well as department and payor specific billing guidelines.

Skills Required:

  • Strong verbal and written communicator
  • Problem-solver
  • Master negotiator
  • Emotional Intelligence
  • Attention to detail

MINIMUM QUALIFICATIONS:

H.S. Diploma,GED,or Equivalent

2 Years of Experience

Must possess some medical billing experience.

A certificate of completion from a medical billing course can be substituted for 1 year of experience

PREFERRED QUALIFICATIONS:

3 Years of Experience

EPIC experience a plus

The current salary range for this position is $23.10 to $31.77

Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.

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About the Company

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Rady Children's Hospital

Our Mission
To restore, sustain and enhance the health and developmental potential of children through excellence in care, education, research and advocacy.

Our Vision
We will be a leader, recognized nationally and internationally, for excellence in patient care, education, research and advocacy.

Rady Children's: Growing with our Community
On August 19, 1954, Rady Children's officially opened to receive its first 12 patients. Since then, nearly 2 million sick and injured children have been treated here. As San Diego has grown, so has our commitment to offering comprehensive care to our community's children. We are the county's only hospital dedicated solely to pediatrics and the region's designated pediatric trauma center. Parents and children come to Rady Children's from across the country to see our nationally renowned physicians. And our focus on research and innovation is helping our patients to receive state-of-the-art care. We believe equally in keeping children well. Through our Center for Healthier Communities and the Chadwick Center for Children and Families, we strive to offer families the promise of a healthier future. And we continue to grow, our new Acute Care Pavilion will help ensure that we will never turn a child away for lack of space.

COMPANY SIZE
2,500 to 4,999 employees
INDUSTRY
Healthcare Services
FOUNDED
1954
WEBSITE
http://www.rchsd.org/