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Cedars-Sinai Biller/Collector III - Physician Billing Office in Torrance, California

The Biller/Collector III

efficiently and effectively bill and collect monies relative to physician

reimbursements. 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.

Essential Job Duties:

-

Coordinate and follow through on the reimbursement activity for specific

patient accounts (e.g. Multi-specialty areas including, but not limited to,

OB/GYN, Hematology/Oncology, Cardiology, Orthopaedic, Urology, Neurology,

Transplant cases, etc).

-

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.

  • Ensure

that all applicable monies are transferred from the hospital so that they may

be posted accordingly.

  • 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.

-

Trains co-workers on advanced or specialized client and billing procedures, as

needed.

Education:

High school diploma or GED required.

Experience:

Minimum five to seven (5-7) years of 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.). Ability to communicate effectively in both verbal and

written form. Ability to work in a changing environment and handle multiple

conflicting priorities.

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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