Revenue Integrity Specialist

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. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Revenue Integrity Specialist Location Cleveland Facility Remote Location Department Weston Reimbursement-Cleveland Clinic Florida Job Code 000460 Shift Days Schedule 7:00am-3:30pm Job Summary Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. Reimbursement Specialists are responsible for policies and protocols related to charge capture coding and billing to ensure compliance for clinical department hired to support. As a Reimbursement Specialist, you will create, revise and maintain department charge documents and/or charge capture systems for technical charges as well as coordinate with professional coding to ensure consistency of charge capture coding. The ideal future caregiver is someone who: •Has a coding certification. •Has experience working with EPIC. •Demonstrates critical thinking skills and decisive judgment. •Is proficient with spreadsheets and word processing applications. This is an excellent opportunity for someone who is looking to work fully remote and join a positive work environment. At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare. Job Details Responsibilities: Complies 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. Cooperates with Management and peers to promote an environment of teamwork and collaboration. Facilitate Revenue Cycle Management 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. Demonstrates successful project management skills by completing projects within designated timeframes, utilizing good planning and project coordination methods, having strong inter-personal communications and organizational skills. Perform Revenue Cycle Management System Prospective Audits, monitoring integrity of internal systems charge capture process and missing revenue opportunities/Recommend corrective strategy. Completes reviews and processes appropriate action(s) to resolve work queues as assigned. Charge capture reconciliation activities to ensure accountability for all services performed and compliance with billing and internal standards. Responsible to 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 and develop network of professional counterparts. Maintains annual mandatory education requirements specific to position as mandated. Performs all other duties as assigned or requested Education: High School Diploma or GED required Associate’s degree preferred. Certifications: 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). Certification in coding clinical specialty hired to support is preferred. Complexity of Work: Requires critical thinking and analytical skills, decisive judgment and the ability to work with minimal supervision. Must have a very strong attention to detail and 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 are essential. Ability to adapt to the technical level of the audience is a must. Ability to work under time sensitive pressures and with multiple assignments concurrently is necessary. Work Experience: Minimum two years extensive CPT, HCPCS, and ICD-10 CM coding and medical billing and reimbursement experience. Healthcare experience required. Epic EHR experience is preferred. Understanding and applying third party and governmental payer regulations. Experience providing education and trend analysis related to revenue and reimbursement. 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 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 follwed 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. Please review the Equal Employment Opportunity poster. Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities We know that fully supporting our caregivers is what creates the best outcomes for our patients. Our outstanding, comprehensive offerings are an investment in your health, well-being and future. What began in Cleveland in 1921 has grown to include locations throughout, the U.S. and even other countries. For you, that means more opportunities to learn, grow and serve patients — while finding caring, thriving communities both at work and at home. Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Headquartered in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 70,800 employees worldwide represent 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 19 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England.