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Cleveland Clinic



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Health Care-Cleveland Clinic
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Job Title

Lead Reimbursement Specialist-Internal Med Admin Job


Reference Title
HR Use Only: Lead Reimbursement Specialist-Internal Med Admin
Hospital: Cleveland Clinic Main Campus & Family Health Centers
Job Code: U22007
Pay Grade: 11
Schedule: Full Time
Shift: Days
Hours: 8am - 5pm flexible
Job Details: Summary: Responsible for product line billing and patient financial business systems across locations. Monitors and resolves problems pertaining to billing reports and indicators. Implements policies, procedures, and oversees reimbursement specialist within the department.

Job Responsibilities: Maintains a current level of knowledge with respect to governmental coding, billing regulations and HCFA policy across multiple Departments/Sections and specialties (including but not limited to inpatient clinics, hospital and hospital outpatient practices). Monitors and resolves problems pertaining to billing reports and indicators. Uses the mainframe billing applications associated with professional and technical billing across Division/Institute system locations. Works closely with patients, PAS, PFS, ORM, Managed Care and primary Divisions/Institutes as well as outside organizations with regard to billing errors, patient complaints, denials, 3rd party payer coverage and other circumstances. Coordinates resources and personnel (where applicable responsible for line management, otherwise provides information to management for decision support) at various sites to assure that the systems do not alter. Responds Division/Institute management in the event of questions covering the financial systems. Other duties as assigned.

Education: Extensive CPT and ICD9 knowledge required. Computer literacy required. Knowledge in medical anatomical terminology required.

Experience: Minimum four years CPT/ICD9 professional coding, medical billing and reimbursement experience. Supervisory experience preferred.

Licensure/Certification/Registration: Certified Professional Coder (CPC) from the American Academy of Professional Coders or Certified Coding Specialist/Physician (CCS/P) from the American Health Information Management Association required.

Physical Requirements: Manual dexterity to operate office equipment. Ability to lift and transport up to fifteen pounds. May require extended periods of standing, walking or sitting. Good visual acuity through normal or corrected vision.

Category: Finance/Information Systems

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