Revenue Cycle Specialist III – Billing and Collections - Professional Billing

Cedars-Sinai Medical Center•Torrance, CA

1d•Remote

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

High School Diploma or GED required
Minimum of 4 years of hospital Revenue Cycle experience required
English speech, spelling, grammar, and simple math skills equivalent to high school level required
Ability to perform relevant mathematical calculations
Must possess computer competency comprised of a detailed knowledge of MS office, Web Vs, Hospital Patient Financial Service Billing Application, i.e. Emdeon, Availity and CS-Link
Detailed knowledge and understanding of regulatory and CSHS policies and procedure governing billing and collections
Successful completion of PRMPT 1

Nice To Haves

College level courses in Finance, Business or Health Insurance preferred
Collection experience highly preferred
Professional billing experience a plus
Follow-up and workers compensation experience a plus
Typing 40 to 45 wpm (45 to 50 wpm preferred)

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
Billing multispecialty claims within established timelines
Initiating dialog with payors, patients and departments
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