Revenue Integrity Specialist

Join Cleveland Clinic Weston Hospital’s team of caregivers that remain on the leading edge of technology and education all while consistently providing patient-centered healthcare. As part of Cleveland Clinic’s Florida region, Weston Hospital is recognized as one of the top hospitals in the Miami-Fort Lauderdale metro area and Florida. Here, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.Cleveland Clinic Florida continues to be committed to achieving excellent outcomes while providing patient-centered medical and surgical care. The Reimbursement Specialist is responsible for policies and protocols related to charge capture coding and billing to ensure compliance for clinical department hired to support. You will create, revise and maintain department charge documents and/or charge capture systems for technical charges.A caregiver in this position works 8:00am—5:00pm or 6:00am—2:30pm.A caregiver who excels in this role will:• Charge capture reconciliation activities to ensure accountabilities for all services performed and compliance with billing and internal standards.• Identify opportunities and efficiencies in charge of capture functions and operations.• Monitor departmental accounts receivable to achieve appropriate reimbursement percentages and conduct denial analysis to maintain financial stability within the department.• Collaborate with Cleveland Clinic contract management for resolution of payment issues.• Conduct revenue reporting analysis of cost associated with performing surgical/medical procedures and recommend fee modifications.• Maintain departmental charge master files and performs ongoing reviews of technical charges per compliance guidelines.• Understand and explain the ongoing changes in third party payer and governmental payment rules to departmental management and clinical staff.• Assist departmental management by providing coding and reimbursement guidelines of new procedures to ensure corporate compliance adherence to capture appropriate revenue.• Other duties include coordinating with the research department and/or department responsible that maintains any applicable CMS device registries to ensure IDE or registry compliance.Minimum qualifications for the ideal future caregiver include:• High School Diploma or GED required• Medical terminology and anatomy/physiology courses.• Computer literacy and Microsoft office products with emphasis on spreadsheets and word processing applications.• Certified Professional Coder (CPC)• OR Certified Outpatient Coder (COC) by Ammerican Academy of Professional Coder (AAPC)• OR Registered Health Information Technologist (RHIT)• OR Registered Health Information Administrator (RHIA)• OR Certified Coding Specialist (CCS) by American Health Information Management (AHIMA).• Four years of extensive CPT, HCPCSII, and ICD-10 CM coding and medical billing and reimbursement experience.• Understanding and applying third party and governmental payer regulations• Experience providing education and trend analysis related to revenue and reimbursement.Preferred qualifications for the ideal future caregiver include:• Certification in coding clinical specialty hired to support.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/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 visionPersonal Protective Equipment:• Follows Standard Precautions using personal protective equipment as required for procedures.Salaries [which may be] shown on independent job search websites reflect various market averages and do not represent information obtained directly from The Cleveland Clinic. Because we value each individual candidate, we invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.