Clinical Revenue Coordinator III
7 days ago
Cedars-Sinai is seeking a highly skilled Medical Claims Specialist III to join our team. As a key member of our Patient Financial Services department, you will play a critical role in ensuring accurate and timely reimbursement for medical services provided by our clinicians.
Key Responsibilities:
- Coding and Compliance: Provide coding and educational support to clinical areas, ensuring compliance with payer coding and billing requirements.
- Insurance Coordination: Coordinate insurance information and review charges in the Epic Charge Review Work queue.
- Feedback and Education: Provide feedback to physicians to increase knowledge of the relationship between charge behavior, compliance, and reimbursement levels.
- Operational Process Improvement: Make recommendations for improved operational processes to ensure timely and accurate billing information.
- Computerized Equipment: Use computerized equipment to receive various medical reports.
- Coding Knowledge: Maintain current CPT and ICD-10 knowledge of assigned areas to ensure coding remains current.
- Charge Input: Input charges and relative insurance information into the Epic Billing and Accounts Receivable system.
- Insurance Eligibility: Verify insurance eligibility and make adjustments to patient accounts as needed.
- Billing Liaison: Work as a billing liaison between patients and offices.
- Coding Development: Assist with identification and development of appropriate coding for new services and procedures.
- Coding Deficiencies: Identify coding deficiencies and recommend corrective action to improve third-party reimbursement and minimize audit liability.
- Reimbursement Maximization: Coordinate the review of medical records and financial accounts with the coding department and providers to maximize reimbursement for procedures performed.
Qualifications:
- Education: High School Diploma or GED required; Bachelor's degree in accounting, finance, or a related major preferred.
- Experience: A minimum of 5 years of experience in billing, accounting, finance, budgeting, financial analysis, or a related field required.
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