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Account Representative II
- Cleveland Clinic (Cleveland, OH)
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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.
The Account Representative performs a specific operational responsibility within a functional unit within Revenue Cycle Management, including customer service, training, insurance billing and follow-up processes for commercial and government payers, insurance verification, cash application, credit balance resolution and/or account reconciliation, and quality review.
A caregiver in this position works Monday - Friday, 8:00am-4:30pm (flexible).
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.
Physical Requirements:
+ Manual dexterity to operate office equipment.
+ May require periods of sitting, standing and the ability to walk to various locations throughout the Foundation to attend meetings; must have normal or correction vision to clearly communicate verbally by phone or in person.
Personal Protective Equipment:
+ Follows standard precautions using personal protective equipment as required.
Pay Range
Minimum hourly: $15.75
Maximum hourly: $21.65
The pay range displayed on this job posting reflects the anticipated range for new hires. 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. The pay range displayed does not include any applicable pay practices (e.g., shift differentials, overtime, etc.). The pay range does not include the value of Cleveland Clinic's benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.).
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
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