Revenue Cycle Specialist I - Commercial Collections

Cedars-Sinai Medical Center is hiring a Revenue Cycle Specialist I for commercial collections. This is a billing support role within Patient Financial Services, working under general supervision and following established practices, policies, and guidelines. It suits someone with a basic knowledge of the assigned area and a general understanding of department functions and the revenue cycle.

What you will do

• Review and submit claims to third party payors, perform account follow-up activities, and update information on accounts.
• 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 liaison between CSRC Services and Clinical Departments in the coordination of 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-party inquiries, including returning calls and doing the research needed to bring accounts to final resolution.
• Keep current CPT and ICD-10 knowledge of assigned areas for accurate assessment of charge review, and stay apprised of rules and regulations affecting coding and reimbursement.
• Review accounts on the OCS report with providers to identify balances approved or declined for further collection activity. If approved, initiate calls to patients to collect on unresolved balances. If declined, set notification in OCS report format so the account is routed to the appropriate work queue for final resolution.
• Escalate fee schedule discrepancies and system errors.
• Participate in department meetings and give feedback to management on how to improve department processes.
• Follow verbal and written instructions to achieve desired results.
• Follow the department's documentation standards and use activity codes properly. Enter data correctly in fields and maintain acceptable levels of speed and accuracy.
• Monitor assigned work queues and workload, ensuring accounts are resolved in a timely and accurate manner. Take initiative on issues or problems by calling them out to a supervisor.
• Process incoming correspondence based on reason code, timely and accurately.
• Ensure information on the account is complete and accurate, and adhere to payment timeline protocol.
• Assist other team members with resolution of accounts when needed.
• Demonstrate detailed knowledge of Cedars-Sinai core patient accounting systems and/or department specific systems, and use them effectively and efficiently.

What they are looking for

This position requires a basic knowledge of the assigned area and a general understanding of department functions and the revenue cycle. Incumbents are expected to organize, prioritize, and perform work in a timely manner within established guidelines, practices, and procedures. The role may be cross-trained in other office functions and provide back-up coverage.

About Cedars-Sinai

Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. It was also awarded the Advisory Board Company's Workplace of the Year. U.S. News & World Report has named it one of America's Best Hospitals.

Benefits

Cedars-Sinai provides a benefit package that includes healthcare, paid time off, and a 403(b).