Revenue Cycle Specialist I (Remote)

Cedars-Sinai Medical Center•Los Angeles, CA

1d•Remote

About The Position

Under general supervision and established practices, policies, and guidelines, the Revenue Cycle Specialist I provides billing support to Patient Financial Services. Work includes reviewing and submitting claims to third-party payors, following up on accounts, and updating account information. The role requires basic knowledge of the assigned area and a general understanding of department functions and the revenue cycle. The specialist organizes, prioritizes, and completes work in a timely manner within established guidelines and may be cross-trained in other office functions to provide backup coverage. The specialist maintains working relationships with Cedars-Sinai Medical Network, Primary Care Clinical Departments, external clients, and patients. They identify, analyze, resolve, and respond to inquiries and concerns, and follow up on accounts to ensure resolution. The position also serves as a liaison between CSRC Services and Clinical Departments to coordinate department-specific responsibilities. Department-specific duties include supporting billing through charge capture to maximize reimbursement; guiding patients through external billing processes; responding to insurance companies and other authorized third parties; and researching accounts through final resolution. The specialist maintains current CPT and ICD-10 knowledge for assigned areas, reviews accounts on OCS reports with providers, and follows the appropriate collection or routing process based on provider decisions. The role also includes escalating fee schedule discrepancies and system errors, monitoring work queues, processing correspondence, maintaining accurate account information and documentation, following payment timelines, and using patient accounting and department systems effectively. The position is remote for approved states: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, and Texas.

Requirements

High school diploma or GED.
At least 1 year of hospital or professional billing and/or collections experience.

Nice To Haves

College-level coursework in finance, business, or health insurance.
Commercial collections experience.

Responsibilities

Develop and maintain working relationships with Cedars-Sinai Medical Network, Primary Care Clinical Departments, external clients, and patients.
Identify, analyze, resolve, and respond to client inquiries, concerns, and issues, and follow up on accounts to ensure resolution.
Serve as a liaison between CSRC Services and Clinical Departments to coordinate department-specific responsibilities.
Support billing through charge capture to maximize reimbursement.
Respond to patients and guide them through external billing processes, such as CSI, Quest, or other outside entities.
Respond to insurance companies and other authorized third parties, including returning calls and researching accounts through final resolution.
Maintain current CPT and ICD-10 knowledge for assigned areas to support accurate charge review and awareness of coding and reimbursement rules.
Review accounts on OCS reports with providers to identify balances approved or declined for further collection activity.
When collection activity is approved, call patients regarding unresolved balances; when declined, enter a notification in the OCS report format so the account is routed to the appropriate work queue.
Escalate fee schedule discrepancies and system errors.
Participate in department meetings and provide management with feedback on process improvements.
Follow verbal and written instructions and department documentation standards, including proper use of activity codes and accurate data entry.
Maintain acceptable speed and accuracy while monitoring assigned work queues and workload and resolving accounts accurately and on time.
Raise issues and problems with the supervisor.
Process incoming correspondence accurately and promptly based on reason code.
Ensure account information is complete and accurate and follow payment timeline protocols.
Assist other team members with account resolution when needed.
Use Cedars-Sinai core patient accounting systems and department-specific systems effectively and efficiently.