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Cleveland Clinic



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Health Care-Cleveland Clinic
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Hospital: Cleveland Clinic Main Campus & Family Health Centers
Job Code: U21010
Pay Grade: 11
Schedule: Full Time
Shift: Days
Hours: 8am - 5pm
Job Details:

Summary: Responsible for policies and protocols to ensure compliance. Creates,revises, and maintains departmental charge documents for professional and technical charges. Assists with registration of new physicians.

Job Responsibilities: Pre-submission audit of provider's coding/documentation and/or monitoring of Professional Fee Coder and Billing/Charge Reconciliation Specialist activities to ensure compliance billing and internal standards are met. Patient accounts receivable management and 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 and work toward resolution of issues. Conducts research analysis of costs associated with performing examinations and surgical/medical procedures along with revenue impact analysis and makes fee modifications. Audits and reconciles each section of department to ensure all billable services/items are charged. Maintains departmental charge master files and routinely reviews professional and technical charges updating per compliance guidelines. Administration of responsibilities associated with departmental expansion . Assists in practice startup for satellite and affiliate programs to ensure corporate compliance adherence as well as all required revenue capture. Other duties as assigned.

Education: Computer literacy required, specifically in Microsoft Office. Must be proficient with spreadsheets and word processing applications. Working knowledge of financial accounting and billing procedures. Medical terminology and anatomy/physiology courses or related experience in order to classify procedure codes.

Experience: Minimum four years extensive CPT and ICD 9 CM coding experience. medical billing and reimbursement experience. Understanding and applying third party and government payor regulations. Experience providing education and trend analysis related to reimbursement.preferred. Licensure/Certification/Registration: CCS-P, CCS, CPC, CPC-H or RHIT credentials may be required within one year.

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.

Category: Finance/Information Systems

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