Revenue Cycle Specialist II

Job Description

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. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an excellent benefits package that includes Health Care, paid time off and a 403(b). 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 Commercial and Government billing and collections support to Insurance Follow up and Accounts Receivable, performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating patient registration on accounts, etc. Positions at this level require expert knowledge, skill and proficiency in specialized functions and multiple 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, specialties, and provide back-up coverage.

In this role you will effectively bill, submit appeals and collect monies relative to physician reimbursements. You will be in charge of monitoring and processing accounts that are both straightforward or may need further research in order to bring resolution. You will work with minimal direction from management to ensure the integrity of the work performed. We work in a team environment to fulfill the mission and goals of the Department.

Qualifications

Requirements:

• High school graduate or GED required.
• Ability to read, write, understand and speak English effectively.
• A minimum of three years professional/physician billing and/or Collection experience – CMS1500 experience a plus. This physician billing experience includes corresponding with patients and insurance companies in resolving patient accounts. Extensive knowledge of insurance carrier procedures. Experience with reading Explanation of Benefits (EOB) statements.

Experience we are seeking:

• Expert knowledge of medical terminology and coding (ICD, CPT, HCPCS, Modifiers, procedure, bill type, diagnosis, and revenue codes).
• Experience with MS office, Web/Vs, Availity and CS-Link preferred.
• Expert knowledge of regulatory and CSHS policies and procedures. Basic understanding of HIPAA and other privacy information guidelines
• Ability to perform business math.
• Successful completion of PRMPT 1.
• Ability to handle multiple tasks in a fast paced and high-volume environment with conflicting demands on time and attention. Ability to prioritize and organize work to complete assignments in a timely, accurate manner.
• Minimum 3 years’ experience in Commercial and Government billing and follow up. Office visits, procedures, outpatient and inpatient preferred.
• Ability to interpret regulations for Commercial Ins, CMS or Medi-Cal
• Professional and courteous demeanor.

About Us

Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.

About the Team

Cedars-Sinai is one of the largest nonprofit academic medical centers in the U.S., with 886 licensed beds, 2,100 physicians, 2,800 nurses and thousands of other healthcare professionals and staff. Choose this if you want to work in a fast-paced environment that offers the highest level of care to people in the Los Angeles that need our care the most.

Req ID : HRC1268782
Working Title : Revenue Cycle Specialist II
Department : MNS PBS Huntington Hospital
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Financial Services
Job Specialty : Patient Billing
Overtime Status : NONEXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $22.07 - $33.11

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