Revenue Cycle Specialist I (Remote)

Cedars-Sinai•Los Angeles, CA

1d•$21 - $31•Remote

About The Position

Under general supervision and following established practices, policies, and guidelines, the Revenue Cycle Specialist I provides billing support to Patient Financial Services. The role reviews and submits claims to third-party payors, follows up on accounts, updates account information, and performs related billing and collections duties. The position requires basic knowledge of the assigned area and a general understanding of department functions and the revenue cycle. The employee organizes, prioritizes, and completes work promptly within established guidelines and may be cross-trained in other office functions or provide backup coverage. The specialist builds and maintains working relationships with Cedars-Sinai Medical Network, Primary Care Clinical Departments, external clients, and patients. The role serves as a liaison between CSRC Services and Clinical Departments, supports department-specific responsibilities, helps patients navigate external billing processes, and responds to inquiries from patients, insurance companies, and other authorized third parties. It also involves maintaining current CPT and ICD-10 knowledge relevant to assigned areas for accurate charge review. The specialist reviews accounts with providers to identify balances approved or declined for further collection activity, initiates patient calls to collect approved unresolved balances, and routes declined accounts for final resolution. The role monitors work queues, processes correspondence, maintains accurate account documentation and data, follows payment timeline protocols, and escalates fee schedule discrepancies, system errors, and other issues. The position also participates in department meetings, provides process-improvement feedback, and uses Cedars-Sinai patient accounting and department-specific systems effectively.

Requirements

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

Nice To Haves

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

Responsibilities

Review and submit claims to third-party payors, follow up on accounts, and update account information.
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; follow up on accounts to ensure resolution.
Serve as a liaison between CSRC Services and Clinical Departments in coordinating department-specific responsibilities.
Support billing through charge capture to maximize reimbursement.
Guide patients through external billing processes, including CSI, Quest, and other outside entities.
Respond to insurance companies and other authorized third-party inquiries, return calls, and conduct research needed to resolve accounts.
Maintain current CPT and ICD-10 knowledge for assigned areas to support accurate charge review.
Review OCS report accounts with providers to identify balances approved or declined for further collection activity.
Call patients to collect unresolved balances approved for collection and route declined balances to the appropriate work queue for final resolution.
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 adhere to department documentation standards and activity-code requirements.
Enter data correctly and maintain acceptable speed and accuracy.
Monitor assigned work queues and workload to resolve accounts accurately and on time; raise issues or problems with a supervisor.
Process incoming correspondence accurately and promptly according to reason code.
Ensure account information is complete and accurate and adhere to 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.