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 TitleAccount Representative II

                        

LocationIndependence

                    

FacilityCC Business Operations Ctr

                     

DepartmentRCM Billing Operations Billing/No response-Finance

                      

Job CodeB15021

                     

ShiftDays

                       

Schedule8:00am-4:30pm

                       

Job Summary

                         

Job Details

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Account Representative II  

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.   

Our team handles the billing and payment of high-end specialty services to which some of the sickest patients in the world travel to Cleveland Clinic to receive care. These are high dollar and high visibility cases with many intricacies. This team understands the complexities of these cases and goes beyond ensuring that the care provided by the medical teams is reimbursed as intended – for both the organization and the patient.  

A caregiver in this position works 8:00am—4:30pm. 

A caregiver who excels in this role will:  

Recommend and provide input to execute customer service programs in accordance with changes in insurance reimbursement regulations and data obtained from various groups. 

Provide supervisor/manager with information to assist department liaison with various departments regarding various issues including contract and reimbursement rules.  

Comply, recommend, and assist with the implementation of various management reporting systems to insure accurate and timely reporting of department goals and results. 

Assist with department audits as required. Participates in meetings with various payors, internal billing groups and other Cleveland Clinic departments to address discrepancies in payment and provides summary data and trend analysis to Managed Care Business Development for use in contract negotiations. 

In conjunction with supervisor, recommend changes in billing practices intended to reduce payor mis-adjudication of claims and identifies contract language or specific payment methodology contributing to errors in payment. 

Maintain data and develop enhancements to database and other various management reporting systems to ensure accurate presentation of trends in payor reimbursement, error rates, and maximize recovery of underpayments. 

Validate new and existing contracts and reimbursement rules/logic. 

 

Minimum qualifications for the ideal future caregiver include:  

High School Diploma or GED. 

Two years patient accounting experience. 

OR Associate's degree can substitute one year of required experience.  

OR Bachelor's degree can substitute two years of the required experience. 

Knowledge of patient accounts which includes customer service, insurance processing, insurance verification and cash application.  

Knowledge of additional specialized functions may be required such as third-party payors, Medicare processing, hospital and physician billing and pricing.  

CPT4/ICD code application.  

Must have excellent verbal and written skills. 

Knowledge of EPIC and billing revenue resolution. 

 

Preferred qualifications for the ideal future caregiver include:  

NE Ohio or Florida Residents. 

 
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/  

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