Biller/Collector Specialist (Los Angeles)

  • Cedars-Sinai
  • Los Angeles, CA, USA
  • Oct 19, 2018
Full time Accounting Admin-Clerical Finance Health Care

Job Description

JOB SUMMARY: The Biller/Collector Specialist is responsible for timely and appropriate billing and collection of monies from Payors on specialized and complex accounts.  In addition, differentiating the Biller/Collector Specialist from Biller Collectors I-III, this positions is responsible for providing advanced, high-caliber problem identification and resolution as it pertains to billing, collections as well as coding.      ESSENTIAL JOB DUTIES (May include all or some of the following): - Follows-up on all assigned accounts from within the IDX/PCS systems in accordance with pre-established goals - Initiates proactive measures that result in account resolution on assigned projects involving specialized or advanced issues - Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect - Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and financial class; authorization/certification/TAR information; claims address; ICD-9 and CPT-4 coding; patient insurance eligibility, patient benefit coverage; patient responsibility - Responds timely and accurately to all incoming correspondence and inquiries from payers, patients, and other appropriate parties - Initiates contact with patients, as necessary - Initiates recommendations and action plans for resolving accounts to operations and client management. - Evaluates accounts to determine any write-offs or corrections required, including duplicate charges - Prepares refund requests for any monies due to patient or insurance company - Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner - Writes appropriate notes in IDX for every account, including any action taken - Writes action plans and account summary of issues and maintains appropriate documentation of all issues and projects. - Handles in a professional and confidential manner all correspondence, documentation, and files - Reviews various reports to identify denials and edits; corrects claims; suggest action plans to eliminate these denials/edits in the future; determines appropriateness for appeal - Prepares write-offs requests for denied claims which cannot be appealed - Reconciles accounts from collection agencies on a monthly basis - Acts as liaison with collection agencies, to include resolution of issues, recalls, and “exception” accounts - Works on special accounts/projects, as requested by management. - Elevates issues, as appropriate, to management - Responsible for specialized processes and accounts - Meets daily and weekly productivity standards - Supports CSMNS core values, policies, and procedures - Meets with clients as needed to discuss issues and report on action plan.

KNOWLEDGE, SKILLS AND EXPERIENCE: - Five (5) or more years experience in a large billing/collection office. - Extensive experience with the Epic system, Outlook, Excel and Word. - Strong data analysis skills. - Strong knowledge of all payer types. - Ability to work on special projects - Knowledge of CPT-4 and ICD-10 coding and reimbursement guidelines. - Ability to work in teams and independently. - Ability to follow directions and manage completion of multiple tasks within specified timeframes. - Demonstrated ability to interact with clients and colleagues in a thoughtful and attentive manner. - Ability to manage multiple priorities, think tactically as well as strategically. - Demonstrating objectivity, delivering results and show initiative and creativity.  

LICENSES/CERTIFICATIONS: - High school diploma or equivalent required. - Certified Procedural Coder (CPC) certification required. les in a professional and confidential manner all correspondence, documentation, and files - Reviews various reports to identify denials and edits; corrects claims; suggest action plans to eliminate these denials/edits in the future; determines appropriateness for appeal - Prepares write-offs requests for denied claims which cannot be appealed - Reconciles accounts from collection agencies on a monthly basis - Acts as liaison with collection agencies, to include resolution of issues, recalls, and “exception” accounts - Works on special accounts/projects, as requested by management. - Elevates issues, as appropriate, to management - Responsible for specialized processes and accounts - Meets daily and weekly productivity standards - Supports CSMNS core values, policies, and procedures - Meets with clients as needed to discuss issues and report on action plan.

 

 

 

James

Qualifications

Listed in Job Description