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Biller/Collector III - Billing Service

Requisition # 18001433 Apply Now

The Biller/Collector III works on specific types of accounts (e.g. transplant cases, cardiothoracic surgeries and other advanced type of special accounts, Prop 99, etc.) in a team environment to fulfill the mission and goals of the Department.  The Biller/Collector III will work independently requiring little supervision from management to ensure the integrity of the work performed. Efficiently and effectively bill and collect monies relative to physician reimbursements.

 

ESSENTIAL JOB DUTIES:

  • Follows-up on all assigned accounts from within the IDX/PCS systems in accordance with pre-established goals
  • Initiates proactive measures that result in account resolution
  • Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect
  • Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and financial class; authorization/certification/TAR information; claims address; ICD-9 and CPT-4 coding; patient insurance eligibility, patient benefit coverage; patient responsibility
  • Responds timely and accurately to all incoming correspondence and inquiries from payers, patients, and other appropriate parties
  • Initiates contact with patients, as necessary
  • Initiates recommendations and action plans for resolving accounts
  • Evaluates accounts to determine any write-offs or corrections required, including duplicate charges
  • Submits claims for secondary payment
  • Prepares refund requests for any monies due to patient or insurance company
  • Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner
  • Writes appropriate notes in IDX for every account, including any action taken
  • Handles in a professional and confidential manner all correspondence, documentation, and files
  • Reviews various reports to identify denials and edits; corrects claims; suggest action plans to eliminate these denials/edits in the future; determines appropriateness for appeal
  • Prepares write-offs requests for denied claims which cannot be appealed
  • Attempts to locate patient/guarantor through direct contact, letter, or other means
  • Speaks with patient/guarantor to find third party sponsorship, settlement, or to begin charity process
  • Investigates the possibility of Medi-Cal linkage
  • Establishes payment arrangements according to pre-set guidelines
  • Prepares correspondence to patient/guarantor, as necessary
  • Receives and answers inquiries or complaints concerning self-pay accounts; gathers information for timely resolution of issues
  • Elevates issues, as appropriate, to the Supervisor
  • Meets daily and weekly productivity standards
  • Supports CSMNS core values, policies, and procedures

 

Customer Service:

  • Applies resolution to patient calls based on established standards and procedures
  • Interprets billing questions and provides clarification
  • Listens and responds to customer service needs with the appropriate level of urgency
  • Develops and maintains rapport with insurance payers, outside agencies, Cedars-Sinai Medical Center, and Cedars-Sinai Medical Network Services
  • Adjusts patient accounts as appropriate, based on the Explanation of Benefits
  • Updates patient accounts based on verified information from the patient/guarantor
  • Prepares correspondence to patients and insurance payers, as necessary
  • Records appropriately detailed notes in IDX and PCS
  • Elevates issues, as appropriate, to the Supervisor
  • Meets daily and weekly productivity standards
  • Supports CSMNS core values, policies, and procedures

 

COMMUNICATION:

  • Meets with Supervisor weekly
  • Works with co-workers in PBS and others to obtain required information on a timely basis and to solve outstanding issues, as appropriate

   

Educational Requirements:  

·  High school diploma or equivalent.  

·  Three (3) or more years experience.   

·  Strong knowledge of various types of insurance and specialties.   

·  Able to handle more difficult accounts.   

·  Familiarity with computer system usage; IDX experience preferred.  

·  Understanding of insurance billing and collection requirements.  

·  Strong knowledge of CPT-4 and ICD-9 coding.  

·  Knowledge of procedures and data flow in a health care organization; experience with physician billing preferred.  

·  Excellent verbal and written communication skills in the English language.  

·  Able to work in a team-oriented environment.  

·  Works on special projects.   

·  Ability to work independently and to be proactive in securing payments and resolving issues.    

  • Working Title: Biller/Collector III - Billing Service
  • Business Entity: Medical Network
  • City: Torrance
  • Job Category: Patient Financial Services
  • Job Specialty: Patient Billing
  • Position Type: Full-time
  • Shift Length: 8 hour shift
  • Shift Type: Day
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Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.

About Our Location

Torrance, California

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