Revenue Cycle Specialist I - Remote Eligible

MedicalVirtual; Los Angeles (CA); Remote; USD 32,000 - 47,000; Full time

Job summary

Cedars-Sinai in Los Angeles seeks a billing support specialist to review and submit claims, follow up on accounts, and ensure timely reimbursement. Under supervision, you’ll work with Patient Financial Services and cross-train in related office functions.

The role requires a high school diploma, some college in finance or health insurance, and at least one year of hospital billing or collections experience; commercial collections a plus. Strong attention to detail and data accuracy are essential.

Qualifications

• High school diploma or GED required.
• College level courses in finance, business, or health insurance preferred.
• A minimum of 1 year of hospital or professional billing and/or collections experience required.
• Commercial collections experience a plus.

Responsibilities

• 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.
• 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 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.

Skills

Billing experience

Patient account follow-up

Accounts receivable knowledge

Education

High school diploma or GED

Job description

Cedars-Sinai in Los Angeles seeks a billing support specialist to review and submit claims, follow up on accounts, and ensure timely reimbursement. Under supervision, you’ll work with Patient Financial Services and cross-train in related office functions.

The role requires a high school diploma, some college in finance or health insurance, and at least one year of hospital billing or collections experience; commercial collections a plus. Strong attention to detail and data accuracy are essential.