Revenue Cycle Specialist III – Billing and Collections - Professional Billing
About The Position
Under general supervision and following established practices, policies, and guidelines, provides payments indexing and posting to Patient Financial Services, performing duties which may include preparing, indexing, and posting payments, performing daily reconciliation, processing payment transfers, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account. Position at this level requires advanced knowledge in specialized functions and a full understanding of the Revenue Cycle. Incumbents work independently and have a strong Customer Service, analytic and problem-solving skills, and can understand, interpret, and explain payor contracts and CSMC Billing and Collections Policy and Practices governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance. Submits appeals and collect monies relative to physician reimbursement. Services as a technical resource (subject matter expert) to others. Incumbents may assist other team members. This position may be cross trained in other Revenue Cycle functions and provide back-up coverage.
Requirements
- Advanced knowledge in specialized functions and a full understanding of the Revenue Cycle
- Strong Customer Service, analytic and problem-solving skills
- Ability to understand, interpret, and explain payor contracts and CSMC Billing and Collections Policy and Practices
- Basic knowledge of basic accounting principles and healthcare billing and collection practices
- Detailed knowledge of medical terminology and coding (ICD, CPT, HCPCS, procedure, bill type, diagnosis and revenue codes)
- Detailed knowledge and understanding of regulatory and CSHS policies and procedures governing billing and collections
- Understanding of payor contracts
- Successful completion of PRMPT 1
- Ability to understand and analyze different bill types and their purpose and/or billing process as needed
- Ability to perform relevant mathematical calculations
- Computer competency including MS office, Web/Vs, Emdeon and CS-Link
- Excellent verbal and written communication
- Professional and courteous demeanor
- Detail and problem-solving aptitude
- Ability to handle multiple tasks frequently and with short timelines
- Demonstrated customer service skills
Nice To Haves
- Typing 40 to 45 wpm (45 to 50 wpm preferred)
- Prioritizes, organizes work, and complete assignments in a timely and accurate manner
- Ability to work and communicate well with others
Responsibilities
- Preparing, indexing, and posting payments
- Performing daily reconciliation
- Processing payment transfers
- Reviewing and submitting claims to payors
- Performing account follow-up activities
- Updating information on patient account
- Researching, analyzing and resolving complex cases and problem accounts
- Submitting appeals and collecting monies relative to physician reimbursement
- Serving as a technical resource (subject matter expert) to others
- Assisting other team members
- Cross-training in other Revenue Cycle functions and providing back-up coverage
- Monitoring assigned work queues and workload, ensuring resolution of accounts in a timely and accurate manner
- Adhering to documentation standards of the department and properly using activity codes
- Accurately billing multispecialty claims within established timelines and initiating dialog with payors, patients and departments
Benefits
- National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles
- Advisory Board Company’s Workplace of the Year
- One of America’s Best Hospitals
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
