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Under general supervision and following established practices, policies, and guidelines, provides patient relations support to Patient Financial Services, performing duties which may include identifying, analyzing, resolving and responding to customer inquiries in the call center, concerns and issues, and following up on accounts to ensure payment and resolution, etc.

Positions at this level require expert knowledge, skill and proficiency in specialized functions and multiple areas of the revenue cycle. Incumbents must have expert knowledge and understanding of regulatory requirements, and CSHS policies governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance. Serves as a technical resource (subject matter expert) to others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in other revenue cycle functions and provide back-up coverage.

• Applies detailed knowledge of and follows all hospital and department policies, procedures (e.g., PHI, PFS employee handbook).
• Demonstrates detailed knowledge of Cedars-Sinai?s core patient accounting systems and/or department specific systems and uses them effectively and efficiently.
• Effectively monitors assigned work queues and workload, ensuring resolve of accounts in a timely and accurate manner. Takes initiative on issues and/or problems by advancing them to supervisor.
• Adheres to documentation standards of the department. Properly uses activity codes. Notes are clear and concise. Correctly enters data in fields. Maintains acceptable levels of speed and accuracy.
• Completes all necessary research and account follow-up activities to resolve inquiries and/or customer complaints. Ensures that the resolution completed meets the patient?s needs.
• Responds to patient, insurance company and other authorized third-party inquiries, including return of calls and research needed to bring account to final resolution.
• Negotiates and documents payment plans within established policies.
• Achieves timely and correct account collection for hospital services. Responsible for initiating collection calls to patients and insurance companies to collect on unresolved accounts. Maintains A/R per department protocol. Reviews accounts on a continuing basis and refers uncollectible accounts to collection agency or attorney on a timely basis. Ensures account is routed to appropriate work queue for approval.
• Independently composes business correspondence accurately and timely. Researches and compiles performance data reports to assist management in evaluating performance.
• May assume lead role in the absence of the team lead and/or supervisor. May assist in the training of staff on CSMC policies and procedures. Assist the team lead or management with updating policies, procedures and job aids when needed.
• Responds timely, effectively and appropriately to deliverables.
• Shares knowledge, time and expertise to assist other members of the team.
• Ensures practices and procedures are inclusive of interpersonal and cultural diversity
• Identifies and responds appropriately to both internal and external customer needs using available resources.

Requirements:

• High School Diploma/GED required. Associate degree in Business and Health Insurance preferred.
• A minimum of 3 years of hospital billing and collection experience, customer service and Call Center experience required.

• Ideal candidates will have ICD-10 coding experience, understand insurance guidelines, attention to detail, the ability to educate providers and staff on insurance and procedures guidelines and at least 1 year of EPIC experience.

Why work here?

We take pride in hiring the best employees. Our talented staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.