Revenue Cycle Business Partner

    Cleveland Clinic
    Cleveland, OH 44101
    Full-time
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    Job Description

    Job Details Responsible for oversight and analysis of Center of Excellence (COE) metrics across multiple Institutes. Partners with Institutes and Center of Excellence to effect change. Coordinates with Center of Excellence to support the service line expansion within Institutes. Facilitates compliance related activity. Collaborates with Project Managers within the COE for projects that drive revenue and branding (e.g., new practices, identification of potential compliance concerns, and documentation initiatives). Serves as point of contact for communicating Institute changes to COE. Serves as primary resource to coordinate questions and response for issues that arise within the Institutes and COE. While we are currently working remotely this position may require to go back to the office at Main Campus. Only Ohio residents will be considered.

    Greater Cleveland residents preferred, as this position will require some in-house work at our Main Campus and Business Operations Center.

    Responsibilities:
    • Initiates the collaboration of service line strategies with key stakeholders (e.g., Center of Excellence, physician onboarding, training needs, new service compliance reviews, etc.)
    • Coordinates and cascades coding and reimbursement information received from COE to Institute leadership.
    • Coordinates resolution of business issues that impact the revenue cycle process, and communicates progress clearly and concisely to key stakeholders.
    • Collaborates with COE relative to guidance and solutions to complex questions.
    • Develops strong working relationships with Institutes and COE leadership to collaboratively seek solutions.
    • Monitors and distributes revenue cycle metrics within the Institutes.
    • Partners with Institute and RCM financial analysts to review reports from financial systems and reports trends to Institute leadership.
    • Partners with COE to reinforce recommended changes to address performance gaps (e.g., denial trends, payor issues, technology, etc.)
    • Trouble shoots reconciliation and denials in collaboration with COE.
    • Participates in development of business plans and revenue stream analysis within the Institute and informs COE of proposed changes. Develops new programs and self-pay packages.
    • Provides support to Institute leadership and stabilization for COE.
    • Coordinates and assists with Revenue Integrity and Managed Care annual pricing and new CPT code review and set-up.
    • Navigates and functions as primary point of contact for questions related to RVU assignments.
    • Coordinates documentation improvement initiatives with Clinical Documentation improvement (CDI), Center of Excellence and other stakeholders.
    • Responsible for onboarding new providers relative to provider enrollment, credentialing, new billing packets and revalidation.
    • Coordinates scheduling of provider orientation through Physician Specialist and COE team.
    • Acts as a designee to support Institute compliance committee and reporting.
    • Facilitates educational needs to administrators, physicians, providers and nurses related to coding and reimbursement.
    • Coordinates Research activities related to ongoing and new studies to support complete and accurate claim submission process.
    • Customer service assistance for Financial Counselors and providers.
    • Other duties as assigned.
    Education:
    • High School Diploma / GED or equivalent required.
    • Associate's Degree in Business Administration or related field preferred.
    • Bachelor's Degree in Business Administration or related field preferred.
    Certifications:
    • Certified Professional Coder (CPC) from the American Academy of Professional Coders or Certified Coding Specialist/Physician (CCS/P), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) from the American Health Information Management Associate preferred.
    Complexity of Work:
    • Coding assessment relevant to the work may be required.
    • Strong communication and problem solving skills.
    • Strong knowledge of coding, revenue cycle process, and enterprise systems.
    • Ability to deal with complex situation with high degree of independence.
    • Critical thinking skills.
    • Ability to operate effectively in a matrix role reporting to Clinical Operations with a dotted line to the assigned Institutes and Center of Excellence.
    Work Experience:
    • A minimum of 5 years of coding and/or reimbursement experience, including 3 years in lead role.
    • Offset: Associates degree and 4 years coding and/or reimbursement experience, including 1 year in lead role.
    • Offset: Bachelor's degree and 3 years of coding and/or reimbursement experience, including a minimum of 1 year in a lead role.
    Physical Requirements:
    • Manual dexterity to operate office equipment.
    • May require extended periods of standing, walking, or sitting.
    • Good visual acuity through normal or corrected vision.
    Personal Protective Equipment:
    • Follows Standard Precautions using personal protective equipment.
    Posting ID: 567943552Posted: 2021-03-11Job Title: Revenue