Job Information
Cleveland Clinic Reimbursement Specialist in Cleveland, Ohio
Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.
Reimbursement Specialists are responsible for policies and protocols related to charge capture coding and billing to ensure compliance for clinical department hired to support. As a Reimbursement Specialist, you will create, revise and maintain department charge documents and/or charge capture systems for technical charges and coordinate with professional coding to ensure consistency of charge capture coding.
The ideal future caregiver is someone who:
Has a coding certification.
Has experience working with EPIC.
Demonstrates critical thinking skills and decisive judgment.
Is proficient with spreadsheets and word processing applications.
At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.
Responsibilities:
Billing/Charge Reconciliation Specialist activities to ensure accountability for all services performed and compliance with billing and internal standards is maintained.
Identifies opportunities and efficiencies in business office functions and operations.
Manages patient accounts receivable and conducts denial analysis.
Monitors departmental accounts receivable to achieve appropriate reimbursement percentages and maintain financial stability within the department.
Analyzes accounts receivable to identify inequities in payment.
Collaborates with CCF contract management for resolution of payment issues.
Conducts revenue-reporting analysis of costs associated with performing examinations and surgical/medical procedures and recommends fee modifications.
Maintains departmental charge master files and performs ongoing reviews of professional and technical charges per compliance guidelines.
Administers responsibilities associated with departmental expansion.
Assists in practice startup, new service lines, and affiliate programs to ensure corporate compliance adherence to capture appropriate revenue.
Completes finance accounting and maps revenue of billable services.
Other duties include research analysis, IDE compliance, and billing follow up.
Other duties as assigned.
Education:
High School Diploma or GED required.
Computer literacy and Microsoft office products with emphasis on spreadsheets and word processing applications.
Medical terminology and anatomy/physiology courses.
Certifications:
- One of the following certifications is required: Certified Professional Coder (CPC) or Certified Coding Specialist Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA) or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA).
Complexity of Work:
Requires critical thinking and analytical skills, decisive judgment and the ability to work with minimal supervision.
Applicant must be able to work under pressure to meet imposed deadlines and take appropriate actions.
Work Experience:
Minimum four years extensive CPT and ICD 9 CM coding and medical billing and reimbursement experience.
Understanding and applying third party and government payer regulations.
Experience providing education and trend analysis related to revenue and reimbursement.
Physical Requirements:
Manual dexterity to operate office equipment.
Ability to lift and transport up to 15 pounds.
May require extended periods of standing, walking or sitting.
Good visual acuity through normal or corrected vision.
Personal Protective Equipment:
- Follows Standard Precautions using personal protective equipment as required for procedures.
Salaries [which may be] shown on independent job search websites reflect various market averages and do not represent information obtained directly from The Cleveland Clinic. Because we value each individual candidate, we invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities