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EDI Unit Assistant III

EDI Unit Assistant III

University of California, San FranciscoEmeryville, CA, United States
3 days ago
Job type
  • Full-time
Job description

Job Summary

The Assistant III position in the EDI unit is responsible for all aspects of EDI production for UCSF Health Patient Financial Services (PFS), Medical Group Business Services (MGBS), UCSF Benioff Children's Hospital Oakland (BCH Oakland), By the Bay Health, UCSF Physicians Group, Community Connect clinic, and Community Hospitals. The EDI production supports all electronic claim production to various payers and clearinghouses, including Medicare, Medi-Cal, Medi-Cal MC, Anthem Blue Cross, Blue Shield, Availity, Optum IEDI, Optum Exchange, Jopari, PNT, and Office Ally. Electronic claim generation represents approximately 95% of all claims production. Monthly claims volume processed can reach up to 150 thousand claims for hospital billing and up to 400 thousand claims for professional billing. The position also supports the Electronic Remittance Advice (ERA) processes for UCSF, MGBS, LPPHC, BCH Oakland, BTBH, UC Physician Group, Community Connect Partners, and Community Connect Hospitals. In addition, this position also supports Electronic Funds Transfer (EFT) processes for UCSF, MGBS, BCH Oakland, LPPHC, UCPG, and Community Hospitals. The ERA / EFT processes represent approximately 80% of all inbound payment transactions to all supported service areas.

Frequent contact with all units in Patient Financial Services and other billing groups, as well as outside entities, such as Health Plans and EDI Clearing Houses, which partner with UCSF in EDI processes.

Frequent access to the following applications : EPIC / APeX, Wells Fargo CEO portal, Clearinghouse EDI portals, ApplicationXtender, Cirius' Billing and Remittance Applications, and various payer sites.

The final salary and offer components are subject to additional approvals based on UC policy.

Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. The hourly salary range for this position is $31.22-$44.69. To learn more about the benefits of working at UCSF, including total compensation, please visit :

Required Qualifications

  • High school graduate or GED certificate.
  • One year EDI / ERA experience in a hospital billing office or vendor environment handing 837I, 837P and 835 file types.
  • An in-depth understanding of all aspects of electronic billing.
  • Knowledge of insurance billing requirements, UB04 and HCFA 1500 claim forms.
  • Good analytical and organizational skills, interpersonal, verbal, and written communication skills.
  • Experience in computer operations, particularly file management and FTP processes.
  • Knowledge of electronic billing systems (i.e., UGS on-line system, Cirius Prebill and Remittance Manager, etc.)
  • Basic knowledge of the EPIC (ApEX) systems
  • Ability to follow directions and written procedures.
  • Must be a motivated individual with a positive attitude and exceptional work ethic.
  • Maintain a working knowledge of copy and fax machines.
  • Superior knowledge of Microsoft Excel and Access required.
  • Basic knowledge of FTP functions.
  • Computer software skills (i.e. Microsoft Applications and E-mail, etc.).
  • Knowledge of the mandated HIPAA regulations for security, PHI and confidentiality is essential.
  • The ability to work onsite Emeryville when required.

Preferred Qualifications

  • Understanding of ICD10, CPT4, HCPCS, DRG.
  • Knowledge of contracts, insurance billing requirements, UB04 claim form, worker's compensation, HMOs, PPOs, capitation, Medicare, Medi-Cal and HIPAA compliance program regulations.
  • Equal Employment Opportunity

    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.

    About UCSF

    At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.

    Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

    Pride Values

    UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

    In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu

    Join us to find a rewarding career contributing to improving healthcare worldwide.

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    Assistant Iii • Emeryville, CA, United States

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