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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.

The Director of Billing Compliance plays a crucial role in supporting the organization's mission and vision by ensuring billing practices are accurate and compliant which helps to maintain the financial health of the organization, support funding for research initiatives, and educate staff, fostering a culture of continuous learning and improvement. Cleveland Clinic is consistently ranked among the top hospitals in the country, known for its innovative and high-quality care. Working here means being part of a prestigious institution with a strong commitment to excellence. The ideal candidate for Cleveland Clinic's Director of Billing Compliance should possess a blend of technical expertise in healthcare billing software and electronic health records systems, leadership skills, and a deep understanding of healthcare regulations.

A caregiver in this position works 8:00AM-5:00PM. Candidates must reside in Ohio, Florida, or Nevada** **to be considered.

A caregiver who excels in this role will:

+ Collaborate with other departments to investigate and resolve reported compliance concerns related to billing compliance.

+ Communicate to the Executive Director of Corporate Compliance any matter that potentially requires external reporting or is deemed potentially illegal, unethical or otherwise inappropriate.

+ Assist clinical institutes, Revenue Cycle Management, and hospital leaders in conducting compliance risk assessments of their billing and coding operations and the implementation of annual work plans to ensure that identified risks are appropriately mitigated.

+ Facilitate, promote and support their implementation of compliance initiatives, documentation and reporting obligations.

+ Participate as a compliance resource and consultant to other departments on the application of coding, documentation and billing regulations and standards related to professional and hospital reimbursement.

+ Attend and present to the CCHS Corporate Compliance Committee and other audiences as requested.

+ Conduct and document audits and reviews of billing operations to assess compliance with regulatory requirements.

+ Collaborate with departments to ensure the implementation of written policies and procedures that reinforce current Federal and State statutes and regulations regarding the submission of claims and Medicare cost reports.

+ Maintain current knowledge of official coding and billing guidelines, regulations and national trends pertaining to Center for Medicare and Medicaid Services (CMS) and Department of Health and Human Services (HHS) requirements as they relate to compliance operations.

+ Maintain awareness of federal, state and local coding and billing compliance issues to monitor their relevance to the CCHS Compliance program.

+ Interact with government regulators and other agency representatives.

+ Other duties as assigned.

Minimum qualifications for the ideal future caregiver include:

+ Bachelors Degree

+ 7 years of experience in health care coding, billing and third-party reimbursement

+ 1 year of management experience

+ Experience with application of billing and coding laws, standards and regulations within healthcare operations, articulating complex information into understandable terms and effectively communicating at all levels within the organization

Preferred qualifications for the ideal future caregiver include:

+ Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P) through the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC)

+ Advanced knowledge of Federal, State and local health care laws and regulations, particularly CMS and other federally funded program regulations and standards and their application to professional and hospital coding, billing, and reimbursement in both inpatient and outpatient settings

+ Experience working with and safeguarding highly confidential and sensitive information

+ Reputation for integrity and willingness to work with higher levels of management

+ Can develop positive working relationships across all levels of the organization

+ Can research and interpret regulatory guidance

+ Can manage demanding workload and adapt to changing priorities

+ Can identify and address multiple perspectives on issues

+ Can lead investigations into root-cause identification and subsequent process-improvement initiatives.

+ Proficiency in Microsoft Excel and PowerPoint

+ Ability to work in Electronic Medical Records (e.g. Epic) and other data systems

+ Certification in Health Care Compliance (CHC) through the Health Care Compliance Association (HCCA)

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:

+ Work typically performed in an office setting with frequent use of computers and telephones.

+ Includes frequent walking and driving of varying distances on campus and at off-site locations.

Personal Protective Equipment:

+ Follows Standard precautions using personal protective equipment.

Pay Range

Minimum hourly: $48.99

Maximum hourly: $74.71

The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities