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 Title

Reimbursement Specialist

                        

Location

Cleveland

                    

Facility

Fairview Hospital

                     

Department

Cardiology Admin-Avon Hospital

                      

Job Code

U21010

                     

Shift

Days

                       

Schedule

7:00am-3:30pm

                       

Job Summary

                         

Job Details

• 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. 

                       

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