1+ months

Biller/Collector Specialist

Torrance, CA 90509
Job Posting: The Biller/Collector Specialist is responsible for timely and appropriate billing and collection of monies from payers on specialized accounts. In addition, differentiating the Biller/Collector Specialist from Biller Collectors I-III, this positions is responsible for providing advanced billing and collection services in the areas of problem identification and resolution, special projects and development of junior staff. ESSENTIAL JOB DUTIES (May include all or some of the following):

Follows-up on all assigned accounts from within the 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 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. Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

**Qualification Requirements/Preferences:**

Education Certifications/Licensure Experience Physical Abilities KNOWLEDGE, SKILLS AND EXPERIENCE:

High school diploma or equivalent

Certified Procedural Coder (CPC) certification REQUIRED.

3-5 years of experience in Coding/Collections at supervisory level.

Extensive experience with BAR, PCS, TES.

Strong data analysis skills

Strong knowledge of all payer types.

Ability to handle more difficult accounts

Ability to work on special projects

Strong knowledge of CPT-4 and ICD-9 coding and reimbursement guidelines.

Ability to work independently and to be proactive in securing payments and resolving issues

Knowledge of procedures and data flow in a health care organization; experience with physician billing required.

Excellent verbal and written communication skills in the English language

Able to work in a team-oriented environment

Ability to effectively communicate with multiple levels in the health system.


The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand and talk or hear. The employee frequently is required to walk; sit; and use hands to finger, handle, or feel. The employee is occasionally required to reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, depth perception, and ability to adjust focus.


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Biller/Collector Specialist

Torrance, CA 90509

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Torrance, CA

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