Billing & Collections Representative II (Casual) - PFS - RCSSD
San Diego, California
- Job ID
- R-342191
- Date posted
- 09/22/2026
Work Location
San Diego, California
Work Shift
Why CHOC?
At CHOC, we strive to be the leading destination of children’s health by providing exceptional and innovative care. We are responsible for the overall health of our community’s pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC’s compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.
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
Pay Range
Minimum $25.20 Midpoint $31.50 Maximum $37.80Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.
This is a casual position which is subject to renewal on 03/31/2026.
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.
Work Environments - Functional Demand:
Physical Activity Requirements:
Physical Activity Lifting
Sensory Requirements:
Environment Requirements:
Non-Discrimination Statement:
CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.
We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn’t align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.
If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.
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