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

  1. Follow-up on all assigned accounts from within the Epic system in accordance with pre-established goals.

  2. Initiates proactive measures that result in account resolution.

  3. Ensures all conditions for payment receipt have been satisfied, which includes, but not limited to:accurate charges patient insurance eligibilityaccurate financial class patient benefit coverageauthorization/certification/TAR information patient responsibilitiesclaims address CPT-4 coding, as applicableICD-10 coding, as applicable

  4. Responds timely and accurately to all incoming related correspondence and inquires from payers, patients and other authorized parties. Reports any trends in incoming correspondence to managers for appropriate follow-up.

  5. Interacts with co-workers and other representatives to obtain required information on a timely basis.

  6. Initiates contact with patients as necessary

  7. Initiates recommendations and actions for resolving patient accounts. Evaluate accounts to determine any write-offs or corrections required, including duplicate charges.

  8. Submit bills to insurance for secondary insurance.

  9. Ensure that all necessary documentation and information is correct according to departmental policies and procedures. Ensure that all documentation is complete for submission to determine ultimate action on patient account.

  10. Answer telephones, patient inquiries, and respond appropriately to written correspondence relative to a patient’s account.

  11. Research and prioritize incoming mail, resubmit denials with proper documentation according to departmental policies and procedures.

  12. Verify correct initial subscriber billing information and update information in the system as necessary.

  13. Prepare refund request for any or all monies due to patient or insurance company as a result off overpayments or forward requests to appropriate individual in charge of processing refund requests.

  14. Post adjustments to accounts in accordance with departmental policies and procedures.

  15. Respond to all phone calls from other departments or insurance companies in an efficient and courteous manner.

  16. Demonstrate teamwork and provide assistance with special projects when assigned.

  17. Create correspondence and provide documentation for effective reimbursements.

  18. Responsible for updating information within the Epic system (charges, adjustments, write-offs, bad debt, refunds to patients/insurance companies, and professional courtesies). Responsible for processing non-sufficient funds checks and ensure follow-up with those patients in these categories.

  19. Clearly document within the patient’s account, actions taken on the account and any other follow-up that was done, including what the expected outcome should be.

Knowledge, Skills and Experience:

· High school diploma or equivalent required.

· Two or more years experience.

· Assertiveness in collections.

·

Familiarity with computer system usage; IDX

experience preferred.

·

Understanding of insurance billing and

collection requirements.

·

Familiarity with 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.

· Some knowledge of insurance types such as HMO, PPO, etc.

· Familiarity with specialty coding.

· Needs minimal supervision.

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.