Lung Transplant Financial Services Specialist

About the Role

Align yourself with an organization with a reputation for excellence. Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company’s Workplace of the Year, recognizing hospitals and health systems nationwide that have outstanding levels of employee engagement.

Responsibilities

• Creates and maintains database systems to store, manage, and track information and data for the assigned department.
• Generates reports using standard report writing from various medical databases and from the CS Link data warehouse.
• Leads and coordinates data collection and data maintenance for both internal and external users as requested.
• Develops and maintains quality control systems required to ensure data quality, reliability, and integrity.
• Performs daily reconciliation of hospital billing charges.
• Generates reports from medical databases and CS Link data warehouse.
• Creates and maintains internal databases to track transplant volumes, productivity, and performance metrics.
• Compiles and summarizes data for presentations and may present findings to management.
• Collaborates with managed care, hospital billing, and professional billing liaisons for optimal financial procedures.
• Reconciles patient accounts for errors and patient complaints regarding billing.
• Performs insurance verification for eligibility and transplant benefits.
• Provides financial clearance of all outpatient transplant clinics, fibro scans, specialty drug infusions, and procedures.
• Provides financial counseling, submits appeals, and coordinates peer-to-peer reviews.
• Performs surgeon organ procurement billing and collection.
• Creates transplant case rate notifications for professional fee disbursement.
• Audits encounters for Medicare cost report validation.
• Performs charge integrity open encounter resolution.
• Applies knowledge of Medicare, Medi-Cal, and commercial managed care regulatory billing guidelines to resolve claim authorization issues.
• Works closely with the transplant multidisciplinary team to improve financial outcomes.
• Supports the Professional Billing work queues by reviewing and correcting errors in patient accounts.

Requirements

• Associate degree/college diploma – a minimum of two years of college with courses in business, accounting, computer science, or comparable education and experience required.
• A minimum of 2 years of financial analysis, accounting, auditing, or related administrative experience, with exposure to healthcare operations including financial clearance, revenue cycle, or transplant financial services preferred.

Skills

• Excellent problem-solving and organizational skills.
• Good interpersonal and communication skills.
• Ability to interact effectively with patients, families, clinical staff, and external partners.
• Proficient in Microsoft Office and electronic health record systems (e.g., CS-Link/Epic).
• Ability to work both independently and collaboratively in a fast-paced environment.

Benefits

• Outstanding benefits package including health insurance and paid vacation.
• 403(b) retirement plan.

Our accomplished and compassionate staff reflects the culturally and ethnically diverse community we serve, fueling innovation in a dynamic, inclusive environment.