Reimbursement Specialist

The Power of Every One

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.

Job Title

Reimbursement Specialist

Location

Cleveland

Facility

Remote Location

Department

Emergency Medicine-Integrated Hospital Care Institute

Shift

Days

Schedule

7:00am-3:30pm

Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.

As a Reimbursement Specialist, you are responsible for policies and protocols related to coding and billing to ensure compliance. You will create, revise and maintain departmental documents for professional and technical charges, assist with the onboarding and monitoring of new physicians and perform various other research duties as needed. This role is critical to the overall functioning and organization of Cleveland Clinic.

A caregiver in this position works days from 7:00AM 3:30PM. This is a fully remote position.

A caregiver who excels in this role will:

• Ensure accountabilities for all services performed and compliance with billing and internal standards is maintained.
• Identify opportunities and efficiencies in business office functions and operations.
• Manage patient accounts receivable and conduct denial analysis.
• Monitor departmental accounts receivable to achieve appropriate reimbursement percentages and maintain financial stability within the department.
• Analyze accounts receivable to identify inequities in payment.
• Collaborate with CCF contract management for resolution of payment issues.
• Conduct revenue-reporting analysis of costs associated with performing examinations and surgical/medical procedures and recommend fee modifications.
• Maintain departmental charge master files and perform ongoing reviews of professional and technical charges per compliance guidelines.
• Administer responsibilities associated with departmental expansion.
• Assist in practice startup, new service lines and affiliate programs to ensure corporate compliance adherence to capture appropriate revenue.
• Complete finance accounting and maps revenue of billable services.
• Conduct research analysis, IDE compliance and billing follow up.

Minimum qualifications for the ideal future caregiver include:

• High School Diploma/GED
• Computer literacy with Microsoft office products with an emphasis on spreadsheets and word processing applications
• Knowledge of medical terminology and anatomy/physiology
• Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Associate (CCA) by American Health Information Management Certification (AHIMA)
• Four years of extensive CPT and ICD 9 CM coding and medical, billing and reimbursement experience
• Understanding of third party and government payer regulations
• Experience providing education and trend analysis related to revenue and reimbursement

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we're dedicated to providing what matters most to you:

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 followed 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.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities.