Revenue Cycle Specialist III (Emergency)

Cedars Sinai • Torrance, CA

128d • $25 - $38

About The Position

The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Hospital, Professional Fee billing and collections. Duties include but are not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account, reviewing and processing credits, posting payments, and account reconciliations. Positions at this level require expert knowledge, skill and proficiency in CS-Link functions and multi-specialty areas of the revenue cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies 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. Serves as a technical resource (subject matter expert) to others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in other revenue cycle functions and provide back-up coverage.

Requirements

• High School Diploma or GED required.
• College level courses in Finance, Business or Health Insurance preferred.
• Minimum of 4 years of professional and/or hospital revenue cycle billing experience required.
• Professional billing experience highly preferred.
• Experience billing for the Emergency Department preferred.

Responsibilities

• Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients.
• Identifies, analyzes, resolves, and responds to client inquiries, concerns, and issues.
• Follows up on accounts to ensure resolution.
• Serves as liaison between CSRC Services and Clinical Departments in the coordination of billing and reimbursement.
• Responds to patient, insurance company, and other authorized third-party inquiries.
• Makes recommendations for improved operational processes.
• Keeps informed of rules and regulations affecting coding and reimbursement.
• Inputs specialty or cosmetic charges, creates manual invoices and follows up for payment.
• Identifies and advances new services for appropriate pseudo-code creation.
• Identifies possible coding deficiencies through charge/medical record review.
• Reviews accounts on OCS report with providers to identify balances approved or declined for further collection activity.
• Initiates collection calls to patients to collect on unresolved balances.
• Attends specialty clinical huddles as requested and participates in group problem-solving.
• Escalates fee schedule discrepancies and system errors.

Benefits

• Health care
• Dental
• Vision
• Paid time off
• 403(b)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Education Level: High school or GED