Cedars-Sinai Biller/Collector II - PBS/ER in Torrance, California
The Biller/Collector II efficiently and effectively bill and collect monies relative to physician reimbursements. The Biller/Collector is in charge of monitoring and processing accounts that are both straightforward or may need further research in order to bring resolution. The Biller/Collector will work with minimal supervision from management to ensure the integrity of the work performed. The Biller/Collector works in a team environment to fulfill the mission and goals of the Department.
Essential Job Duties:
Follow-up on all assigned accounts from within the Epic system in accordance with pre-established goals.
Initiates proactive measures that result in account resolution.
Ensures all conditions for payment receipt have been satisfied, which includes, but not limited to:
accurate charges patient insurance eligibility
accurate financial class patient benefit coverage
authorization/certification/TAR information patient responsibilities
claims address CPT-4 coding, as applicable
ICD-10 coding, as applicable
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.
Interacts with co-workers and other representatives to obtain required information on a timely basis.
Initiates contact with patients as necessary
Initiates recommendations and actions for resolving patient accounts. Evaluate accounts to determine any write-offs or corrections required, including duplicate charges.
Submit bills to insurance for secondary insurance.
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.
Answer telephones, patient inquiries, and respond appropriately to written correspondence relative to a patient’s account.
Research and prioritize incoming mail, resubmit denials with proper documentation according to departmental policies and procedures.
Verify correct initial subscriber billing information and update information in the system as necessary.
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.
Post adjustments to accounts in accordance with departmental policies and procedures.
Respond to all phone calls from other departments or insurance companies in an efficient and courteous manner.
Demonstrate teamwork and provide assistance with special projects when assigned.
Create correspondence and provide documentation for effective reimbursements.
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.
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.
High School graduate or GED required.
Minimum 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.
Proven ability to handle multiple conflicting tasks.
Experience with online Accounts
Receivable billing systems (Epic system experience a plus). Knowledge of PC based software applications
(e.g. Outlook, Word, Excel, etc.). Type
Ability to communicate
effectively in both verbal and written form.
Ability to work in a changing environment and handle multiple
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.