Revenue Cycle Specialist I - Commercial Collections

Align yourself with an organization that has a reputation for excellence! 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. We also were awarded the Advisory Board Company’s Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.

What will you be doing in this role?

Under general supervision and following established practices, policies, and guidelines, provides billing support to Patient Financial Services, performing duties which include reviewing and submitting claims to third party payors, performing account follow-up activities, updating information on account, etc.. Positions at this level require a basic knowledge of assigned area, and 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. This position may be cross-trained in other office functions and provide back-up coverage. Duties include:

• Develops and maintains excellent working relationships with Cedars-Sinai Medical Network, Primary Care Clinical Departments, external clients, and patients. Performs duties that include identifying, analyzing, resolving, and responding to our client’s inquiries, concerns, issues, and following up on accounts to ensure resolution.
• Serves as liaison between CSRC Services and Clinical Departments in the coordination of Department-Specific Responsibilities Additional primary duties and responsibilities that are only performed in the specific department(s) below: Department Duties and Responsibilities billing through charge capture to maximize reimbursement. Responds to patients and guide them through external billing processes, such as CSI, Quest, or other outside entities. Also responds to insurance companies, and other authorized third-party inquiries, including the return of calls and research needed to bring accounts to final resolution. Keeps apprised of rules and regulations affecting coding and reimbursement by maintaining current CPT and ICD-10 knowledge of assigned areas for accurate assessment of charge review.
• Review accounts on 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 to ensure the account is routed to the appropriate work queue for final resolution. Escalation of fee schedule discrepancies and system errors.
• Participates in department meetings and provides feedback to management on how to improve department processes. Adheres to instructions, verbal and written, to achieve desired results.
• Adheres to documentation standards of the department and properly uses activity codes. Correctly enters data in fields. Maintains acceptable levels of speed and accuracy.
• Effectively monitors assigned work queues and workload, ensuring resolve of accounts in a timely and accurate manner. Takes initiative on issues and/or problems by calling them out to supervisor.
• Processes incoming correspondence, based on reason code, timely and accurately.
• Ensures information on the account is complete and accurate. Adheres to payment timeline protocol.
• Adheres to payment timeline protocol and assists other team members with resolution of accounts when needed.
• Demonstrates detailed knowledge of Cedars-Sinai core patient accounting systems and/or department specific systems and uses them effectively and efficiently.

Originally posted on Himalayas