Revenue Cycle Specialist II (Physician Billing)

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 times 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 offer an outstanding benefits package that includes health care, 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 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.

*Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas*

Qualifications

Requirements:

• High school diploma 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.

Why work here?

Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.

Diversity and Inclusion at Cedars-Sinai

Our compensation philosophy

Cedars-Sinai is an Equal Employment Opportunity 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 April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy.