Billing Specialist II

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:

Associates 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 were 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.

Pay Range

Minimum hourly: $16.47

Maximum hourly: $23.61

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 candidates actual compensation will be determined after taking factors into consideration such as the candidates work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinics 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