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Billing Specialist II

extra holidays - extra parental leave

Remote:

Full Remote

Contract:

Full time

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

High school diploma or GED, Three years related experience in pharmacy billing, Knowledge of outpatient pharmacy billing codes, Familiarity with medical and pharmacy terminology, General knowledge of accounting software.

Key responsabilities:

Perform billing and accounts receivable functions
Research, analyze, and reconcile patient account receivables
Oversee accounts receivable processes for accuracy
Generate end reports and complete audits
Provide training on third-party billing policies

Cleveland Clinic XLarge https://www.clevelandclinic.org/

10001 Employees

See more Cleveland Clinic offers

Job 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

Billing Specialist II

Location

Cleveland

Facility

Remote Location

Department

RCM Special Billing-Finance

Job Code

B16015

Shift

Days

Schedule

8:00am-5:00pm

Job Summary

Job Details

**THIS POSITION IS OPEN TO OHIO RESIDENTS ONLY**

Billing Specialist 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.

As a Billing Specialist II, you will perform billing and accounts receivable functions to support the Retail/Specialist Pharmacy.

A caregiver in this position works Days, from 8:00am—5:00pm.

A caregiver who excels in this role will:

Research, analyze and reconcile patient account receivables, refunds and revenue cycle functions.

Oversee accounts receivable process to ensure accuracy and timely reimbursement of invoices.

Process and apply manual checks to appropriate accounts.

Generate weekly and monthly end reports to show account activity.

Complete retrospective payer audits and prospective internal audits and provide feedback of results to the billing leadership team.

Assist with training pharmacy caregivers regarding third-party billing policies and procedures as needed.

Provide input into the development, implementation, and evaluation of third-party billing policies and procedures.

Daily review of A/R system to monitor overpayment, underpayments, non-payments and other irregularities.

Facilitate routine correspondence with insurance payers, clearinghouse and patients regarding missing payments, missing remittance advice, discrepancies, etc.

Troubleshoot payment processing issues and identify payer trends, opportunities for payment processing and quality assurance improvements.

Minimum qualifications for the ideal future caregiver include:

High school diploma or GED.

Three years of related experience with accounting and billing functions in a pharmacy environment such as retail, specialty or home delivery pharmacy.

Knowledge of billing codes for outpatient pharmacy charges, (NDC, HCPCS, CPT, J-codes, ICD-10) codes and formal documents necessary for billing (i.e. UB04, CMS-1500, EOB).

Knowledge of billing rules and reimbursement guidelines for Medicare (Part B and Part D), Medicaid and commercial insurance payers.

Familiarity with medical and pharmacy terminology and knowledge of basic accounting functions.

General knowledge of spreadsheets, accounting and/or billing software and payer websites/portals.

Preferred qualifications for the ideal future caregiver include:

Associate’s degree in accounting, healthcare or a related field.

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:

Typical physical demands include manual dexterity sufficient to perform computer functions of the job.

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