Revenue Integrity Specialist

Cleveland Clinic • Cleveland, OH

68d

About The Position

Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. The Revenue Integrity Specialist is a clinical auditing resource that has an understanding of IT clinical and non-clinical applications and its use within patient care workflows for revenue integrity. A caregiver in this role will have a solid understanding of policies/procedures and regulatory requirements related to charge capture and billing to ensure compliance. The position functions in a team environment within the Revenue Integrity department. A caregiver in this position works remotely out of Ohio, Florida, or Nevada, Monday-Friday from 8:30am-4:30pm.

Requirements

• High School Diploma or GED required.
• Minimum two years of CPT, HCPCS, and ICD-10 CM coding and/or medical billing and reimbursement experience.
• One of the following certifications is required: Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) by American Academy of Professional Coder (AAPC), Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) by American Health Information Management (AHIMA).
• Healthcare experience required.
• Understanding and applying third party and governmental payer regulations.
• Experience providing education and trend analysis related to revenue and reimbursement.
• Must have very strong attention to detail and be able to demonstrate strong organizational and time management skills.
• Excellent oral and written communication skills.
• Able to work successfully with a diverse group of constituents including senior and midlevel leadership, Physicians and a wide range of end users.
• Ability to adapt to the technical level of the audience.
• Ability to work under time sensitive pressures and with multiple assignments concurrently.

Nice To Haves

• Associate's degree preferred.
• Certification in coding clinical specialty hired to support is preferred.
• Epic EHR experience is preferred.

Responsibilities

• Comply with established corporate and departmental policies, procedures, objectives, quality assurance methods, and safety codes.
• Demonstrates compliance with licensing, regulatory and accrediting agency provisions as required.
• Consistently demonstrates appropriate and professional communication behavior toward patients, customers, and coworkers.
• Facilitate Revenue Cycle Management by identifying and recommending charge capture revenue opportunities, system data flow issues, prospective coding and revenue integrity audits, claim error resolution strategies and overall financial health.
• Assist departmental management by providing coding and reimbursement guidelines of new procedures to ensure corporate compliance adherence to capture appropriate revenue.
• Demonstrate successful project management skills by completing projects within designated timeframes, utilizing good planning and project coordination methods.
• Perform Revenue Cycle Management System Prospective Audits, monitoring integrity of internal systems, charge capture process and missing revenue opportunities.
• Complete reviews and processes appropriate action(s) to resolve work queues as assigned.
• Charge captures reconciliation activities to ensure accountabilities for all services performed and compliance with billing and internal standards.
• Identify and research issues to promote appropriate and consistent coding billing practices in collaboration with Revenue Integrity Analyst.
• Assist in special projects in relation to coding & reimbursement to facilitate revenue for new acquisitions, departments, service lines & changes in regulation.
• Perform projects, requests and other duties as assigned by Revenue Integrity department team members.
• Maintain Professional growth/development & current certifications through Seminars, workshops, professional affiliations to keep abreast of latest trends.
• Maintain annual mandatory education requirements specific to position as mandated.

Benefits

• Comprehensive health insurance.
• Retirement plans.
• Paid time off.
• Continuing education opportunities.
• Employee wellness programs.

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED