Revenue Cycle Specialist III (Gastroenterology)

Cedars-Sinai Medical Center is hiring a Revenue Cycle Specialist III to support gastroenterology billing and collections. This role is for someone with expert knowledge of CS-Link and multi-specialty revenue cycle functions, who can resolve complex accounts with minimal help and serve as a technical resource to others. The position is remote, but you must live in one of the approved states listed below.

What you will do

• Submit clean, accurate claims to payors and follow up to resolve outstanding balances.
• Build and maintain working relationships with Cedars-Sinai clinical departments, external clients, and patients. Identify, analyze, and resolve inquiries and issues, and follow up on accounts to ensure resolution.
• Act as liaison between CSRC Services and clinical departments to coordinate billing and reimbursement.
• Respond to patient, insurance company, and other authorized third-party inquiries, including return calls and research needed to bring accounts to final resolution.
• Recommend improvements to operational processes so billing information is received from client groups in a timely and accurate manner.
• Keep current with CPT and ICD-10 knowledge for assigned areas to accurately assess charge review.
• Input specialty or cosmetic charges, create manual invoices, and follow up for payment. Direct billing to the correct entity (Vision Plan, Personal Family, or Non-Covered). Distribute payments to avoid inaccurate billing to patients. Discuss cash pricing for cosmetic services and cash packages with patients and manage credits for package and/or cosmetic services.
• Identify and advance new services for appropriate pseudo-code creation.
• Identify possible coding deficiencies through charge and medical record review, and coordinate coding review to ensure accurate charge capture, enhance third-party reimbursement, and minimize audit liability.
• Review accounts on the OCS report with providers to identify balances approved or declined for further collection activity. If approved, initiate collection calls to patients. If declined, set notification in OCS report format to route the account to the appropriate work queue.
• Attend specialty clinical huddles as requested and participate in group problem-solving.
• Escalate fee schedule discrepancies and system errors.
• Research and resolve denied or underpaid claims. Prepare and submit timely, accurate written appeals with supporting clinical and billing documentation according to payer guidelines.
• Maintain detailed documentation of appeal activity in Epic, ensuring compliance with internal policies and audit readiness.

What they are looking for

You need expert knowledge, skill, and proficiency in CS-Link functions and multi-specialty areas of the revenue cycle. You must have expert understanding of regulatory requirements, payor contracts, and CSHS policies governing billing and collections, and be able to interpret them soundly. You should be able to research, analyze, and resolve complex cases and problem accounts with minimal assistance. You will serve as a subject matter expert to others and may act in the absence of the lead or supervisor. This position may be cross-trained in other revenue cycle functions and provide back-up coverage.

Location

This is a remote position. Approved remote states: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas.

About Cedars-Sinai

Cedars-Sinai was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings. The organization has more than 14,000 employees.