At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.
We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.
Job TitleReimbursement Specialist
LocationCleveland
FacilityFairview Hospital
DepartmentCardiology Admin-Avon Hospital
Job CodeU21010
ShiftDays
Schedule7:00am-3:30pm
Job Summary
Job Details
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.
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.
Please be advised that caregivers in this position will work in a hybrid model, meaning some on-site days at the listed physical location are required. This position requires residence in Northeast Ohio to be considered. This position
requires **2-3 days on-site – 1 day remote**
A caregiver who excels in this role, will:
- 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.
Minimum qualifications for the ideal caregiver include:
- 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.
- 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).
- 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.
Preferred qualifications for the ideal caregiver include:
- Experience coding cardiology cases.
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Has experience working with EPIC.
-
Demonstrates critical thinking skills and decisive judgment.
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Is proficient with spreadsheets and word processing applications.
Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link to see how we provide what matters most to you: https://jobs.clevelandclinic.org/benefits-2/
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
Top Skills
What We Do
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit, multispecialty academic medical center that integrates clinical and hospital care with research and education.
Founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation, Cleveland Clinic has become one of the largest and most respected hospitals in the country.
Cleveland Clinic facilities can be found throughout Northeast Ohio, as well as around the country and world including:
Cleveland Clinic Florida
Cleveland Clinic Canada
Cleveland Clinic Abu Dhabi
Cleveland Clinic Lou Ruvo Center for Brain Health - Las Vegas
Cleveland Clinic health system includes eight regional hospitals, 16 family health centers, a children's hospital for rehabilitation and one affiliate hospital. Cleveland Clinic is accredited by The Joint Commission, the nation’s largest accreditor of healthcare organizations.
Our family health centers offer:
Outpatient care
Primary care
Numerous subspecialties
Numerous locations
All of our hospitals, family health centers, outpatient clinics and home healthcare programs are also accredited by The Joint Commission under its hospital accreditation program.
