Revenue Cycle Specialist III (Emergency)

About the Organization

Cedars-Sinai has been awarded the National Research Corporation’s Consumer Choice Award for 19 consecutive years for providing the highest-quality medical care in Los Angeles. The organization has also received the Advisory Board Company’s Workplace of the Year award, recognizing outstanding employee engagement. U.S. News & World Report has named Cedars-Sinai one of America’s Best Hospitals. An amazing benefits package is provided, including health care, dental, vision, paid time off, and a 403(b) retirement plan.

Responsibilities

• Review and submit claims to payors, perform account follow-up activities, update patient account information, review and process credits, post payments, and reconcile accounts.
• Research, analyze, and resolve complex cases and problem accounts with minimal assistance, serving as a subject matter expert in CS-Link functions and multi-specialty areas of the revenue cycle.
• Develop and maintain excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, addressing inquiries, concerns, and issues.
• Act as a liaison between Revenue Cycle Services and Clinical Departments to coordinate billing and reimbursement.
• Respond to patient, insurance company, and third-party inquiries, including follow-up research to resolve accounts.
• Recommend improvements for operational processes to ensure timely and accurate billing information from client groups.
• Maintain current knowledge of CPT and ICD-10 coding for assigned areas to ensure accurate charge review.
• Input specialty or cosmetic charges, create manual invoices, and follow up for payment, directing billing to the correct entity (e.g., Vision Plan, Personal Family, or Non-Covered).
• Distribute payments to avoid inaccurate billing and discuss cash pricing for cosmetic services with patients.
• Manage credits for package and/or cosmetic services.
• Identify and advance new services for appropriate pseudo-code creation and address coding deficiencies through charge/medical record review.
• Review accounts on OCS reports with providers to identify balances approved or declined for further collection activity; initiate collection calls or route accounts for final resolution.
• Attend specialty clinical huddles, participate in problem-solving, and escalate fee schedule discrepancies and system errors.
• May be cross-trained in other revenue cycle functions and provide back-up coverage.

Requirements

• High School Diploma or GED required; college-level courses in Finance, Business, or Health Insurance preferred.
• Minimum of 4 years of professional and/or hospital revenue cycle billing experience required; professional billing experience highly preferred.
• Experience billing for the Emergency Department preferred.
• Expert knowledge of regulatory requirements, payor contracts, and CSHS policies governing billing and collections.
• Sound interpretation of billing and collection policies and the ability to serve as a technical resource for others.

Benefits

• Health care coverage (medical, dental, vision).
• Paid time off.
• 403(b) retirement plan.

About the Team

The team reflects the culturally and ethnically diverse community Cedars-Sinai serves, embodying a commitment to creating a dynamic, inclusive environment that fuels innovation and sets the gold standard for patient care.