Coding and Reimbursement Director
Apply NowCompany: Cleveland Clinic Foundation
Location: Cleveland, OH 44130
Description:
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
Coding and Reimbursement Director
Location
Cleveland
Facility
Remote Location
Department
Enterprise Him Admin-Finance
Job Code
T99720
Shift
Days
Schedule
8:00am-5:00pm
Job Summary
Job Details
Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.
As the Director of Coding and Reimbursement, you will oversee the vision, strategy and operations of Technical Coding Services, Audit, Education and/or Denials across the Cleveland Clinic enterprise. In this role, you will ensure accurate and compliant coding and charge capture for acute care, ambulatory offices and/or physician offices while partnering with Clinical Documentation Integrity (CDI) for accurate documentation. You will serve as a liaison to various departments, physicians and Allied Health professionals and collaborate with other revenue cycle and clinical leaders to execute enterprise-wide initiatives and goals. Ultimately, your work in the office helps enhance patient support and allow caregivers to continue serving our communities every day.
Candidates being considered reside in Ohio, Florida or Nevada. The caregiver will work remotely from 8:00AM - 5:00PM.
A caregiver who excels in this role will:
Minimum qualifications for the ideal future caregiver include:
Preferred qualifications for the ideal future caregiver include:
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:
Personal Protective Equipment:
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 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
Coding and Reimbursement Director
Location
Cleveland
Facility
Remote Location
Department
Enterprise Him Admin-Finance
Job Code
T99720
Shift
Days
Schedule
8:00am-5:00pm
Job Summary
Job Details
Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.
As the Director of Coding and Reimbursement, you will oversee the vision, strategy and operations of Technical Coding Services, Audit, Education and/or Denials across the Cleveland Clinic enterprise. In this role, you will ensure accurate and compliant coding and charge capture for acute care, ambulatory offices and/or physician offices while partnering with Clinical Documentation Integrity (CDI) for accurate documentation. You will serve as a liaison to various departments, physicians and Allied Health professionals and collaborate with other revenue cycle and clinical leaders to execute enterprise-wide initiatives and goals. Ultimately, your work in the office helps enhance patient support and allow caregivers to continue serving our communities every day.
Candidates being considered reside in Ohio, Florida or Nevada. The caregiver will work remotely from 8:00AM - 5:00PM.
A caregiver who excels in this role will:
- Establish and drive strategy, execution of initiatives, program goals and objectives.
- Monitor performance, issues and risks.
- Routinely collaborate with Clinical Documentation Improvement (CDI) work group on accurate documentation and coding to improve quality outcomes and foster accurate reimbursement (i.e. patient safety indicators (PSIs), hospital acquired conditions (HACs), diagnoses present on admission (POA), complications and comorbid conditions, risk adjustment models, clarification queries and education).
- Develop and maintain standardized practices, processes, metrics, policies and procedures and guidelines across the enterprise to reduce front-end issues and ensure accurate reimbursement and patient satisfaction.
- Serve as liaison to Institutes and Market leaders regarding technical and/or professional coding, reimbursement and customer service-related issues.
- Develop training programs for coders, medical staff and ancillary personnel.
- Develop management reporting systems to ensure accurate and timely reporting of goals and results.
- Oversee and monitor resolution of patient and insurance inquiries and the coding compliance program, including conducting and overseeing coding audit efforts, reporting non-compliance issues detected and collaborating with key stakeholders on action plans.
- Monitor changes in regulatory coding, compliance with documentation guidelines and testing compliance with regulations.
- Direct technology optimization and automation solution initiatives, including initiating, evaluating and implementing in collaboration with ITD, providers and other success partners.
Minimum qualifications for the ideal future caregiver include:
- Bachelor's Degree and eight years of relevant experience OR High School Diploma/GED with 13 years of experience
- Registered Health Information Administrator certification (RHIA), Registered Health Information Technician certification (RHIT), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) Certifications through the American Health Information Management Association is required.
- Advanced skills in Microsoft Office or Client 365 and MS Teams
- Demonstrated team, leadership, organizational, financial management and problem-solving skills
Preferred qualifications for the ideal future caregiver include:
- Master's Degree
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:
- Ability to communicate and exchange accurate information.
- Ability to perform work in a stationary position for extended periods.
- Ability to work with physical records or operate a computer or other office equipment.
- In some locations, ability to travel throughout the hospital system.
- In some locations ability to move up to 25 lbs.
Personal Protective Equipment:
- Follows standard precautions using personal protective equipment (PPE) 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