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Cedars-Sinai Biller/Collector III - Physician Reimbursement Services in Torrance, California

The Biller/Collector III will efficiently and effectively bill and collect monies relative to physician reimbursements. 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. Works independently requiring little supervision from management to ensure the integrity of the work performed.

Job Duties and Responsibilities:

  • 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, Orthopedic, Urology, Neurology, Transplant cases, etc).

  • Initiates measures that result in account resolution.

  • Ensures all conditions for payment receipt have been satisfied.

  • 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 acquire required information on a timely basis.

  • Initiates contact with patients as needed.

  • 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 vital documentation and information is accurate 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 accurate documentation.

  • Verify accurate initial subscriber billing information and update information in the system as required.

  • 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 detail 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 sophisticated or specialized client and billing procedures, as needed.

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Education:

High school diploma or GED required.

Experience:

Five to seven (5-7) years experience performing medical billing functions. 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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