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Cedars-Sinai Biller/Collector II - Billing Services in Torrance, California

The Biller/Collector is responsible for timely and appropriate billing to and collection of monies from payors and/or patients. Position will work in the payment department with the remit team assisting with many tasks such as locating payments, reconciling electronic remittance, EFT and ERA enrollment, wire transfers, reconciling bank reports and working remit work queue's.

Job Duties and Responsibilities:

  • 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 needed

  • 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 friendly 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; captures information for timely resolution of issues

  • Elevates issues, as appropriate, to the Supervisor

  • Meets daily and weekly efficiency standards

Education:

High school diploma or GED required.

Experience:

  • Three to five (3-5) years experience performing medical billing functions.

  • Minimum 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 with online Accounts Receivable billing systems (Epic system experience a plus). Knowledge of PC based software applications (e.g. Outlook, Word, Excel, etc.).

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.

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