Reimbursement Specialist

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 conducts 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 recommends 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: https://jobs.clevelandclinic.org/benefits-2/