UC Irvine Classification Specifications
Patient Biller

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Class Specifications – H.45

4660 – Patient Biller V
4662 – Patient Biller IV
4663 – Patient Biller III
4664 – Patient Biller II
4665 – Patient Biller I

June, 1992

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SERIES CONCEPT

Patient Billers are responsible for initial billing procedures for patient care and for subsequent actions required to assure correct, expeditious payment of bills and perform other related duties as assigned.

Incumbents apply a complete knowledge of private insurance, government programs, and uninsured patient billing procedures, as well as a knowledge of University procedures, such procedures being complex and subject to frequent revision.  Billers maintain and use rate manuals and computer-generated data in initiating correct billing procedures; follow-up by telephone, personal inquiry, or statement to the proper source; review all accounts monthly; interpret carrier payments; verify accuracy of payments using knowledge of disallowances and percentage payments; and make corrections as necessary.

CLASS CONCEPT

Patient Biller V

Under general supervision, incumbents supervise Patient Billers in assigned unit; monitor and adjust workload; develop procedures; review and interpret regulations and their impact on current systems; adapt systems to meet those needs; and act as technical resource to staff.

Patient Biller IV

Under general supervision, incumbents gather service-based data and act as liaison to corresponding department representatives; ct as a resource to staff; review and resolve problems/more complex accounts requiring a broad-based knowledge of all payor requirements; compile production reports and perform Patient Biller III duties.  Incumbents may assume lead responsibility for lower level Patient Billers and supervisor’s duties in supervisor’s absence or may supervise large groups of Level I and II Billers as a primary function.

Patient Biller III

Under supervision, incumbents pursue collections on patient account balances from insurance carriers, legal representatives, or any other outside agency having inquiries/complaints related to patient accounts.  Duties may also include auditing, researching, adjusting, re-billing and cross-billing accounts to follow-up on claims through denial and appeal processes; updating online patient account system; use of electronic media for submission and follow-up of claims; and receiving, reviewing and collecting data on hospital/patient claims prior to billing.

Patient Biller II

Under supervision, incumbents typically audit accounts, prepare and complete third-party claims for electronic/hard copy submission; identify and post payments to individual accounts; perform patient billing; balance case accounts; identify, prepare and apply contractual allowances; initiate telephone inquiries to identify payments and remittances; photocopy various billing documents; update online patient account system; review patient correspondence to determine if self-pay accounts may be billable; and establish liability accounts.

Patient Biller I

Under close supervision, incumbents sort, match, file, locate, and retrieve billing documents and patient account files.  Incumbents also perform general clerical assistance in photocopying material, paper sorting, stapling and document delivery.  Incumbents may assist higher level Patient Billers by initiating routine telephone inquiries, preparing patient payment files, assisting patients with routine procedural billing questions, and assisting in the maintenance of patient billing systems.  This is the entyr level of the series.