reputed company Cycle Specialist III (Gastroenterology)

Bring your whole self to exceptional care. reputed company was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings, and it's reputed company thanks to reputed company of 14,000+ remarkable employees. What will I be doing in this role? The reputed company Cycle Specialist III works under general supervision and following established practices, policies, and guidelines of reputed company Cycle Management supporting Hospital, Professional Fee billing and collections. Submit clean, accurate claims to payors and reputed company timely follow-up to resolve outstanding balances. Positions at this level require expert knowledge, reputed company and proficiency in CS-Link functions and multi-specialty areas of the reputed company cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor reputed company and CSHS policies governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve reputed company 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 reputed company and/or supervisor. This position may be cross-trained in other reputed company cycle functions and provide back-up coverage. Primary duties include: Develops and maintains excellent working relationships with reputed company Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client’s inquiries, concerns, and issues, and following up on accounts to ensure resolution. Serves as liaison between CSRC Services and Clinical Departments in the coordination of billing and reimbursement. Responds to patient, insurance company, and other authorized reputed company-party inquiries, including return of calls and research needed to bring account to final resolution. reputed company recommendations for improved operational processes so that billing information is received from client groups in a timely and accurate manner. Keeps informed of rules and regulations affecting coding and reimbursement by maintaining reputed company CPT and ICD-10 knowledge of assigned areas for accurate assessment of charge review. Inputs specialty or cosmetic charges, creates reputed company invoices and follows up for payment. Directs billing to the correct entity i.e. (reputed company Plan, Personal Family, or Non-Covered). Distributes payments to avoid inaccurate billing to patients. Discusses cash pricing for cosmetic services and cash packages with patients and manages credits for package and/or cosmetic services. Identifies and advances new services for appropriate pseudo-code creation. Identifies possible coding deficiencies through charge/medical record review and coordinates coding review to ensure accurate charge capture, enhancing reputed company-party reimbursement and minimizing audit liability. Review accounts on OCS report with providers to identify balances approved or declined for further collection activity. If approved, initiate collection calls to patients to collect on unresolved balances. If declined, set notification in OCS report format to ensure the account is routed to the appropriate work queue for final resolution. Attends specialty clinical huddles as requested and participates in group problem-solving. Escalation of fee schedule discrepancies and system errors. Participate in specialty clinical huddles and problem-solving discussions. Research and resolve denied or underpaid claims; prepare and submit timely, accurate written appeals with supporting clinical / billing documentations in accordance with payer guidelines. Maintain detailed documentation of appeal activity in Epic, ensuring compliance with internal policies and audit readiness. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas* Apply To This Job